A prospective study of patient reported urinary incontinence among American, Norwegian and Spanish men 1 year after prostatectomy
Objective: To compare pre- and post-radical prostatectomy (RP) responses in the urinary incontinence domain of Expanded Prostate Cancer Index Composite-26 (EPIC-26) in cohorts from the USA, Norway and Spain. Methods: A prospective study of pre- and 1-year post-treatment responses in American (n=537)...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-04-01
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| Series: | Asian Journal of Urology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214388219300803 |
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| Summary: | Objective: To compare pre- and post-radical prostatectomy (RP) responses in the urinary incontinence domain of Expanded Prostate Cancer Index Composite-26 (EPIC-26) in cohorts from the USA, Norway and Spain. Methods: A prospective study of pre- and 1-year post-treatment responses in American (n=537), Norwegian (n=520) and Spanish (n=111) patients, establishing the prevalence of urinary incontinence defined according to published dichotomization. Thereafter we focused on the response alternatives “occasional dribbling”, pad use and problem experience. A multivariate logistic regression analysis (significance level ≤ 0.01) considered risk factors for “not retaining total control”. Results: Compared to the European men, the American patients were younger, healthier and more presented with lower risk tumors. Before RP no inter-country differences emerged the prevalence of urinary incontinence (6%). One-year post-treatment urinary incontinence was described by 30% of the American and 41% of the European patients, occasional dribbling being the most frequent type of urinary leakage. In the multivariate analysis the risk of “not retaining total control” increased almost 3-fold in European compared to American patients, with age and co-morbidity being additional independent risk factor. Conclusion: After RP patients from Spain and Norway reported more unfavorable outcomes by EPIC-26 than the American patients to most of the urinary incontinence items, the difference between the European and American patients remaining in the multivariate analysis. The most frequent post-RP response alternative “occasional dribbling” needs to be validated with pad weighing as “gold standard”. Keywords: Prostate cancer, Radical prostatectomy, Urinary incontinence, Adverse effects |
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| ISSN: | 2214-3882 |