Age at surgery, educational level and long-term urinary incontinence after radical prostatectomy.

Abstract:

OBJECTIVE:To identify predictors for long-term urinary leakage after radical prostatectomy. PATIENTS AND METHODS:A consecutive series of 1411 patients who underwent radical prostatectomy (open surgery or robot-assisted laparoscopic surgery) at Karolinska University Hospital between 2002 and 2006 were invited to complete a study-specific questionnaire. Urinary leakage was defined as use of two or more pads per day. RESULTS:Questionnaires were received from 1288 (91%) patients with a median follow-up of 2.2 years. Age at surgery predicts in an exponential manner long-term urinary incontinence at follow-up with an estimated relative increase of 6% per year. Among the oldest patients, 19% had urinary incontinence compared with 6% in the youngest age group, translating to a prevalence ratio of 2.4 (95% confidence interval [CI], 1.5-8.1). Low educational level, as compared with high, yielded an increased age-adjusted prevalence ratio of 2.5 (95% CI, 1.7-3.9). Patients who had undergone salvage radiation therapy had an increased prevalence of urinary incontinence (2.5; 95% CI, 1.6-3.8), as did those with respiratory disease (2.4; 95% CI, 1.3-4.4). Body mass index, prostate weight, presence of diabetes or previous transurethral resection did not appear to influence the prevalence of urinary incontinence. CONCLUSIONS:In this series, a patient's age at radical prostatectomy influenced, in an exponential manner, his risk of long-term urinary incontinence. Other predictors are low educational level, salvage radiation therapy and respiratory disease. Intervention studies are needed to understand if these data are relevant to the prevalence of urinary leakage if a radical prostatectomy is postponed in an active monitoring programme.

journal_name

BJU Int

journal_title

BJU international

authors

Nilsson AE,Schumacher MC,Johansson E,Carlsson S,Stranne J,Nyberg T,Wiklund NP,Steineck G

doi

10.1111/j.1464-410X.2011.10231.x

subject

Has Abstract

pub_date

2011-11-01 00:00:00

pages

1572-7

issue

10

eissn

1464-4096

issn

1464-410X

journal_volume

108

pub_type

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