Advertisement

Purpose:

After radical prostatectomy continence is commonly defined as no pads except a security pad or 0 to 1 pad. We evaluated the association of pad status and urinary quality of life to determine whether security and 1 pad status differ from pad-free status to better define 0 pads as the post-prostatectomy standard.

Materials and Methods:

A total of 500 consecutive men underwent robot assisted radical prostatectomy from October 2003 to July 2007. Data were collected prospectively and entered into an electronic database. Postoperatively men completed self-administered validated questionnaires including questions on 1) daily pad use (0, security, 1, or 2 or more), 2) urine leakage (daily, about once weekly, less than once weekly or not at all), 3) urinary control (none, frequent dribbling, occasional dribbling or total control), 4) American Urological Association symptom score and 5) urinary quality of life.

Results:

Postoperatively men who indicated 0 pad use had a mean ± SE symptom score of 5.8 ± 0.3 and pleased quality of life (1.16 ± 0.08). In contrast, men with a security pad and 1 pad had a symptom score of 7.6 ± 0.7 and 9.2 ± 0.6 but mixed quality of life (2.78 ± 0.18 and 3.41 ± 0.15, respectively, p <0.0005).

Conclusions:

Results show a significant decrease in quality of life between no pads (1.16 or pleased), a security pad and 0 or 1 pad (2.78 and 3.41 or mixed, respectively). Findings do not support defining continence with a security pad or 0 to 1 pad. Continence should be strictly defined as 0 pads.

References

  • 1 : Postprostatectomy incontinence: all about diagnosis and management. Eur Urol2009; 55: 322. Google Scholar
  • 2 : Potency, continence and complication rates in 1,870 consecutive radical retropubic prostatectomies. J Urol1999; 162: 433. LinkGoogle Scholar
  • 3 : Urinary incontinence following treatment of localized prostate cancer. Cancer Control2001; 8: 532. Google Scholar
  • 4 : Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: the Prostate Cancer Outcomes Study. JAMA2000; 283: 354. Google Scholar
  • 5 : Prospective patient-reported continence after laparoscopic radical prostatectomy. Urology2001; 58: 570. Google Scholar
  • 6 : Variation in continence and potency by definition. J Urol2003; 170: 1291. LinkGoogle Scholar
  • 7 : Prospective assessment of patient reported urinary continence after radical prostatectomy. J Urol2000; 164: 744. LinkGoogle Scholar
  • 8 : Urinary incontinence after radical prostatectomy: incidence by definition, risk factors and temporal trend in a large series with a long-term follow-up. BJU Int2006; 97: 1234. Google Scholar
  • 9 : Continence following radical retropubic prostatectomy using self-reporting instruments. J Urol2004; 171: 1212. LinkGoogle Scholar
  • 10 : Patient-reported urinary continence and sexual function after anatomic radical prostatectomy. Urology2000; 55: 58. Google Scholar
  • 11 : Prediction of urinary continence following radical prostatectomy. Urol Int1998; 60: 80. Google Scholar
  • 12 : Post-robotic prostatectomy urinary continence: characterization of perfect continence versus occasional dribbling in pad-free men. Urology2006; 67: 785. Google Scholar
  • 13 : Assessment of early continence recover after radical prostatectomy: patient reported symptoms and impairment. J Urol2001; 166: 958. LinkGoogle Scholar
  • 14 : Differences in urologist and patient assessments of health related quality of life in men with prostate cancer: results of the CaPSURE database. J Urol1998; 159: 1988. LinkGoogle Scholar
  • 15 : The American Urological Association symptom index for benign prostatic hyperplasia: The Measurement Committee of the American Urological Association. J Urol1992; 148: 1549. LinkGoogle Scholar
  • 16 : Effect of radical prostatectomy for prostate cancer on patient quality of life: results from a Medicare survey. Urology1995; 45: 1007. Google Scholar
  • 17 : The impact of open radical retropubic prostatectomy on continence and lower urinary tract symptoms: a prospective assessment using validated self-administered outcome instruments. J Urol2004; 171: 1216. LinkGoogle Scholar

Departments of Urology and Medicine (KO), University of California-Irvine, Orange, California

Advertisement