How Does Age Affect Urinary Continence following Robot-Assisted Radical Prostatectomy? A Prospective...

Area of Science:

• Urology
• Oncology
• Geriatrics

Background:

• Robot-assisted radical prostatectomy (RARP) is a common treatment for prostate cancer.
• Urinary continence outcomes after RARP can vary, particularly in older men.
• Existing studies have limitations in assessing age-related differences in post-RARP urinary function.

Purpose of the Study:

• To evaluate the impact of patient age on urinary continence following robot-assisted radical prostatectomy.
• To address data limitations at the extremes of age in previous research on RARP outcomes.
• To provide a comprehensive analysis of age as a factor in post-prostatectomy urinary function.

Main Methods:

• Analysis of 5,648 patients undergoing primary RARP for prostate cancer from Australian prospective databases (2008-2019).
• Assessment of urinary bother and pad usage at 12 months post-RARP using the EPIC-26 questionnaire.
• Multivariable logistic regression to determine the relationship between age and urinary continence outcomes.

Main Results:

• Urinary bother significantly increased with age groups: <55 (4.2%), 55-64 (6.8%), 65-74 (9.1%), and ≥75 (12.9%).
• Pad-free rates decreased with age: <55 (86%), 55-64 (79%), 65-74 (68%), and ≥75 (50%).
• Younger men (<55) had significantly lower odds of bother compared to 65-69 year olds; no significant difference in bother was found for older age groups (≥70 or ≥75).

Conclusions:

• Urinary bother and pad usage post-RARP are excellent in younger men but deteriorate with advancing age.
• Despite increased pad usage in older patients, the likelihood of being "significantly bothered" by incontinence shows a less pronounced age-related increase.
• Age is a significant factor influencing urinary continence after RARP, with outcomes generally worsening in older populations.