Comparison of various continence definitions in a large group of patients undergoing radical prostatectomy: a multicentre, prospective study

Abstract

Background Due to the usage of various measurement methods and definitions, comparing continence rates after radical prostatectomy is a challenging task. This study compares continence rates based on different methods and aims to identify the definition for continence which agrees best with the patients’ subjective assessment of continence. Additionally, continence was controlled for multiple influencing factors. Methods This prospective multicentre study was carried out in seven hospitals throughout Germany. Before and at 3, 6, and 12 months after surgery self-reporting questionnaires were completed and returned by 329 (84.4%) of 390 eligible patients. The questionnaires were independently evaluated and analysed by a third party. Association of continence with demographic, operative, and tumour factors in an ongoing comprehensive prostate cancer database was evaluated. Results The continence rate drops substantially for patients undergoing radical prostatectomy but increases again with time. Concrete numbers vary considerably depending on definition – 44% at 3 months and 68% at 12 months after surgery (0 pads) vs. 71 and 90% (0–1 pads). Significant confounding variables regarding continence rate are nerve-sparing procedure, categorized Gleason score, rehabilitative cure treatment, and pelvic floor training. The definition of 0 pads for continence coincides greater than 0–1 pads with the patients’ self-assessment of being continent. Conclusion A standardized definition for continence would be desirable, as it is one of the most important preconditions to guarantee sound comparison of continence rates. Since there are enough other factors that make comparison difficult, we suggest using the definition of “0 pads”. It is easily measured objectively, leaves no room for interpretation, and agrees best with the patients’ self-assessment. Electronic supplementary material The online version of this article (10.1186/s12894-019-0500-6) contains supplementary material, which is available to authorized users.

What is the impact of post‐radical prostatectomy urinary incontinence on everyday quality of life? Linking Pad usage and International Consultation on Incontinence Questionnaire Short‐Form (ICIQ‐SF) for a COMBined definition (PICOMB definition)

“…Classically, some definitions of UC after RP have been considered based on pad usage (DEF 1: 0 pads; DEF 2: 0–1 safety pad; DEF 3: 0–1 pads) or the ICIQ‐SF (DEF 4: ICIQ score = 0 and therefore ICIQ 1 = 0 and ICIQ 2 = 0) 6,7,11 …”

Extraperitoneal Robotic Laparo-Endoscopic Single-Site Plus1-Port Radical Prostatectomy Using the da Vinci Single-Site Platform

“…A PSA value greater than 0.2 ng/mL is defined as PSA recurrence after RP [ 11 ]. The continence rate was defined as using 0 pads during the follow up period [ 12 ].…”

Early outcomes of robot-assisted radical prostatectomy following completion of a structured training curriculum: a single surgeon cohort study

“…16 Hence, 3- and 12-month continence outcomes were available until September 2019 and January 2019, respectively. Complete continence was defined as use of 0 pads per 24 h and social continence was defined as use of ⩽1 pad per 24 h. 17,18…”

“…16 Hence, 3-and 12-month continence outcomes were available until September 2019 and January 2019, respectively. Complete continence was defined as use of 0 pads per 24 h and social continence was defined as use of ⩽1 pad per 24 h. 17,18 Operative times were not recorded. In view of a known high level of subjectivity bias for NS reporting, 19 information on grades and laterality of NS is not given.…”