A prospective study of patient reported urinary incontinence among American, Norwegian and Spanish men 1 year after prostatectomy

• Type of Material: Article
• Authors: Anne Holck Storås, Oslo University Hospital; Martin Sanda, Emory University; Olatz Garin, Universitat Pompeu Fabra Barcelona; Peter Chang, Harvard Medical School; Dattatraya Patil, Emory University Hospital; Catrina Crociani, Harvard Medical School; Jose Francisco Suarez, Hospital Universitary de Bellvitge; Milada Cvancarova, Oslo University Hospital; Jon Havard Loge, Oslo University Hospital; Sophie D. Fosså, Oslo University Hospital
• Language: English
• Date: 2020-04-01
• Publisher: Elsevier Science Inc.
• Publication Version: Final Published Version
• Copyright Statement: © 2020 Editorial Office of Asian Journal of Urology.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.ajur.2019.08.001
• Title of Journal or Parent Work: Asian Journal of Urology
• Volume: 7
• Issue: 2
• Start Page: 161
• End Page: 169
• Grant/Funding Information: The study was funded by a grant from Health-Region South. East, Norway (No. 8324).
• Keywords: Comparative approach; Prostate cancer; Urinary incontinence; Radical prostatectomy; Adverse effects; Oncology; European men; American men; Prospective study; Published dichotomization
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Public Health; Health Sciences, Medicine and Surgery; Health Sciences, Oncology

Abstract

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”.