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The burden of urinary incontinence and urinary bother among elderly prostate cancer survivors.

Abstract：

BACKGROUND:Data describing urinary health in elderly, community-dwelling prostate cancer (PCa) survivors are limited. OBJECTIVE:To elucidate the prevalence of lower urinary tract symptoms, urinary bother, and incontinence in elderly PCa survivors compared with peers without PCa. DESIGN, SETTING, AND PARTICIPANTS:A cross-sectional analysis of 5990 participants in the Osteoporotic Fractures in Men Research Group, a cohort study of community-dwelling men ≥ 65 yr. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:We characterized urinary health using self-reported urinary incontinence and the American Urological Association Symptom Index (AUA-SI). We compared urinary health measures according to type of PCa treatment in men with PCa and men without PCa using multivariate log-binomial regression to generate prevalence ratios (PRs). RESULTS AND LIMITATIONS:At baseline, 706 men (12%) reported a history of PCa, with a mean time since diagnosis of 6.3 yr. Of these men, 426 (60%) reported urinary incontinence. In adjusted analyses, observation (PR: 2.11; 95% confidence interval [CI], 1.22-3.65; p=0.007), surgery (PR: 4.41; 95% CI, 3.79-5.13; p<0.0001), radiation therapy (PR: 1.49; 95% CI, 1.06-2.08; p=0.02), and androgen-deprivation therapy (ADT) (PR: 2.02; 95% CI, 1.31-3.13; p=0.002) were each associated with daily incontinence. Daily incontinence risk increased with time since diagnosis independently of age. Observation (PR: 1.33; 95% CI, 1.00-1.78; p=0.05), surgery (PR: 1.25; 95% CI, 1.10-1.42; p=0.0008), and ADT (PR: 1.50; 95% CI, 1.26-1.79; p<0.0001) were associated with increased AUA-SI bother scores. Cancer stage and use of adjuvant or salvage therapies were not available for analysis. CONCLUSIONS:Compared with their peers without PCa, elderly PCa survivors had a two-fold to five-fold greater prevalence of urinary incontinence, which rose with increasing survivorship duration. Observation, surgery, and ADT were each associated with increased urinary bother. These data suggest a substantially greater burden of urinary health problems among elderly PCa survivors than previously recognized.

journal_name

Eur Urol

journal_title

European urology

authors

Kopp RP,Marshall LM,Wang PY,Bauer DC,Barrett-Connor E,Parsons JK,Osteoporotic Fractures in Men MrOS Research Group.

doi

10.1016/j.eururo.2013.03.041

subject

Has Abstract

pub_date

2013-10-01 00:00:00

pages

672-9

issue

eissn

0302-2838

issn

1873-7560

pii

S0302-2838(13)00295-9

journal_volume

pub_type

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The burden of urinary incontinence and urinary bother among elderly prostate cancer survivors.