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Use of Surgery for Post-Prostatectomy Incontinence.

Marc Nelson1, Ryan Dornbier1, Eric Kirshenbaum1

  • 1Loyola University Medical Center, Maywood, Illinois.

The Journal of Urology
|October 24, 2019
PubMed
Summary
This summary is machine-generated.

Stress urinary incontinence after prostatectomy affects 3.6% of men. Surgical interventions like urethral slings or artificial urinary sphincters are effective but may be underutilized and delayed, impacting quality of life.

Keywords:
artificialprostatectomyprostatic neoplasmssuburethral slingsurinary incontinenceurinary sphincter

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Area of Science:

  • Urology
  • Surgical Oncology
  • Health Services Research

Background:

  • Stress urinary incontinence (SUI) is a common complication following radical prostatectomy.
  • Surgical options, including urethral slings and artificial urinary sphincters (AUS), offer effective treatment for persistent post-prostatectomy incontinence.
  • Conservative measures often fail, necessitating surgical intervention for improved patient outcomes.

Purpose of the Study:

  • To analyze the current utilization patterns of surgical treatments for post-prostatectomy incontinence.
  • To identify patient and clinical factors associated with undergoing incontinence surgery after radical prostatectomy.
  • To assess the temporal trends in surgical intervention for SUI in this population.

Main Methods:

  • Utilized Healthcare Cost and Utilization Project (HCUP) databases from Florida (2006-2015).
  • Identified men who underwent radical prostatectomy (2006-2012) and tracked subsequent SUI surgeries (urethral sling or AUS) through 2015.
  • Employed descriptive statistics and multivariable logistic regression to identify predictors of surgery.

Main Results:

  • 3.6% (1,068/29,287) of men underwent SUI surgery a median of 23.5 months post-prostatectomy.
  • Predictors for surgery included age (61-70, 71-80 years), Medicare insurance, and higher Charlson Comorbidity Index.
  • Older age, Medicare, and comorbidities were associated with increased odds of receiving surgical treatment.

Conclusions:

  • SUI surgery rates after radical prostatectomy appear low (3.6%).
  • The performance and timing of post-prostatectomy incontinence surgery may be delayed.
  • Prompt surgical repair of severe or refractory incontinence can significantly enhance post-prostatectomy quality of life.