Urinary continence after radical prostatectomy: the patient perspective.

Area of Science:

• Urology
• Oncology
• Patient-Reported Outcomes

Background:

• Radical prostatectomy (RP) is a common treatment for prostate cancer.
• Postoperative urinary incontinence is a significant concern affecting quality of life.
• Standard methods for assessing continence may not fully capture patient experience.

Purpose of the Study:

• To compare the 0-1 pad definition of urinary continence with patient self-reported outcomes after RP.
• To determine if patient questionnaires provide more accurate continence status rates.
• To identify factors influencing postoperative urinary continence.

Main Methods:

• A cohort of 873 men undergoing RP between 1998 and 2006 was evaluated.
• Patients completed questionnaires on postoperative urinary incontinence.
• Baseline and pathological factors were analyzed for their impact on continence.

Main Results:

• Patient self-reports indicated 65.2% continence, versus 85.1% by the pad definition.
• 93.4% of pad-free patients felt continent, compared to 24.5% of those using one pad daily.
• Younger men (<65 years) reported continence faster (3.6 months) than older men (>65 years, 4.7 months).
• Neurovascular bundle resection negatively affected continence.

Conclusions:

• Patient-reported outcomes via validated questionnaires at 24 months post-RP are crucial for accurate continence assessment.
• Age and neurovascular bundle resection are key factors influencing continence recovery.
• Routine follow-up should incorporate patient-perspective questionnaires to complement objective measures.