Incontinence After Radical Prostatectomy: A Patient Centered Analysis and Implications for Preoperative Counseling

Martin, Aaron; Nakamura, Leah; Nuñez, Rafael N.; Wolter, Christopher E.; Humphreys, Mitchell R.; Castle, Erik P.

doi:10.1016/j.juro.2011.02.2698

Cited by 33 publications

(30 citation statements)

References 16 publications

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“…5 It is reported that approximately 4-22% of patients do not achieve urinary continence 12 months after RARP. 4,[6][7][8][9] Recent studies reported that preoperative clinical factors, anatomical characteristics, and surgical techniques are significantly associated with urinary incontinence after RARP. 1,7,[10][11][12][13][14][15] Of these factors, membranous urethral length (MUL) is an important factor that directly correlates with the functional sphincter mechanism.…”

Section: Introductionmentioning

confidence: 99%

Impact of preoperative and postoperative membranous urethral length measured by 3 Tesla magnetic resonance imaging on urinary continence recovery after robotic-assisted radical prostatectomy

Song

Kim²,

Park³

et al. 2017

CUAJ

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Introduction: We sought to investigate the impact of preoperative and postoperative membranous urethral length (MUL) on urinary continence using 3 Tesla (3T) magnetic resonance imaging (MRI) after robotic-assisted radical prostatectomy (RARP). Methods: Between 2008 and 2013, 190 men with RARP underwent preoperative and postoperative MRI. Patients who received adjuvant radiotherapy or who were lost to followup were excluded, leaving 186 patients eligible for analysis. Preoperative MUL was estimated from the prostate apex to the penile bulb, while postoperative MUL was estimated from the bladder neck to penile bulb. Patients with no pads or protection were considered to have complete continence. Logistic regression analysis was used to identify predictors associated with urinary incontinence at six and 12 months. Results: Age was commonly associated with urinary incontinence at six and 12 months. In addition, diabetes mellitus (DM) was another factor associated with urinary incontinence at 12 months. When adjusting these variables, preoperative MUL ≤16 mm (95% confidence interval [CI] 1.01-1.14; p=0.022), postoperative MUL ≤14 mm (95% CI 1.16-9.80; p=0.025) and percent change of MUL >18% (95% CI 1.17-7.23; p=0.021) were significantly associated with urinary incontinence at six months. However, at 12 months, preoperative MUL ≤13.5 mm (95% CI 1.85-19.21; p=0.003) and postoperative MUL ≤13 mm (95% CI 1.24-13.84; p=0.021) had impacts on urinary incontinence, but not percent change of MUL. Conclusions: Preoperative and postoperative MUL were significantly associated with urinary continence recovery after RARP. Therefore, efforts to preserve MUL are highly recommended during surgery for optimal continence outcomes after RARP.

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Section: Introductionmentioning

confidence: 99%

Impact of preoperative and postoperative membranous urethral length measured by 3 Tesla magnetic resonance imaging on urinary continence recovery after robotic-assisted radical prostatectomy

Song

Kim²,

Park³

et al. 2017

CUAJ

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“…Wang & Eriksson, 2014) e trinta e três estudos observacionais (Anderson et al, 2012;Bach et al, 2011;Berge et al, 2013;Bradford et al, 2010;Choi et al, 2011;Dahl et al, 2014;Froehner et al, 2012;Geraerts et al, 2013;Guilger et al, 2011;Hartz et al, 2013;Holm et al, 2013;Inoue et al, 2009;Kimura et al, 2011;Koehler et al, 2012;Ku et al, 2009;Lee et al, 2012;Lin et al, 2012;Martin et al, 2011;Namiki et al, 2012;Namiki et al, 2009;Nyarangi-Dix et al, 2013;Parker et al, 2011;Pfalzgraf et al, 2014;Santa Mina et al, 2014;Santa Mina et al, 2010;Thompson et al, 2014;Thornton et al, 2012;Treiyer et al, 2011;van der Poel et al, 2013;R. Wang et al, 2012;Willis et al, 2012).…”

Section: Características E Resultados Dos Estudos Incluídosunclassified

“…Outros nove estudos (Choi et al, 2011;Froehner et al, 2012;Geraerts et al, 2013;Holm et al, 2013;Martin et al, 2011;Santa Mina et al, 2014;Santa Mina et al, 2010;R. Wang et al, 2012) foram agrupados na categoria Ênfase no domínio urinário, apresentando-se como a segunda categoria com o maior número de estudos.…”

Section: Características E Resultados Dos Estudos Incluídosunclassified

“…Ao analisarmos o delineamento de pesquisa, observou-se delineamento quantitativo em trinta e nove estudos (Anderson et al, 2012;Bach, Döring, Gesenberg, Möhring, & Goepel, 2011;Berge et al, 2013;Bradford et al, 2010;Choi et al, 2011;Dahl et al, 2014;Delongchamps, Belas, Saighi, Zerbib, & Peyromaure, 2013;Froehner et al, 2012;Geraerts et al, 2013;Guilger et al, 2011;Hartz et al, 2013;Holm, Fosså, Hedlund, & Dahl, 2013;Imbimbo et al, 2011;Inoue et al, 2009;Kimura et al, 2011;Koehler et al, 2012;Ku et al, 2009;Lee et al, 2012;Lin, Yu, Lin, Yang, & Kao, 2012;Martin et al, 2011;Mehnert, Lehmann, Graefen, Huland, & Koch, 2010;Miyazato et al, 2014;Namiki et al, 2012;Namiki, Ishidoya, Tochigi, Ito, & Arai, 2009;NyarangiDix, Radtke, Hadaschik, Pahernik, & Hohenfellner, 2013;Parker, Wang, He, & Wood Jr, 2011;Pfalzgraf et al, 2014;Ratcliff, Cohen, Pettaway, & Parker, 2013;Santa Mina et al, 2014;Santa Mina et al, 2010;Sugimoto, Tsunemori, & Kakehi, 2009;Thompson et al, 2014;Thornton, Perez, Oh, & Crocitto, 2012;Treiyer, Anheuser, Bütow, & Steffens, 2011;E. Y. Wang & Eriksson, 2014;R.…”

Section: Características Metodológicas Dos Estudosmentioning

confidence: 99%

“…Y. Wang & Eriksson, 2014;R. Wang et al, 2012;Willis et al, 2012), onze estudos foram utilizadas associações de instrumentos específicos à genéricos Hartz et al, 2013;Holm et al, 2013;Imbimbo et al, 2011;Inoue et al, 2009;Namiki et al, 2012;Namiki et al, 2009;Ratcliff et al, 2013;Santa Mina et al, 2014;Treiyer et al, 2011) em quatro estudos foram utilizados instrumentos específicos de sintomas urinários e/ou incontinência ou sintomas intestinais (Froehner et al, 2012;Guilger et al, 2011;Martin et al, 2011;Pfalzgraf et al, 2014), em três estudos foram utilizados instrumentos genéricos (Geraerts et al, 2013;Mehnert et al, 2010;Thorsteinsdottir et al, 2013), em dois estudos foram utilizados questionários elaborados pelos próprios autores (Delongchamps et al, 2013;Thompson et al, 2014), e em dois estudos foram utilizados instrumentos específicos da próstata (Ku et al, 2009;Santa Mina et al, 2010). O instrumento mais utilizado foi o EPIC, usado em treze estudos, seguido do UCLA-PCI, em nove estudos, seguido do SF-12 que foi usado em cinco estudos e SF-36 em outros cinco estudos.…”

Section: Embora Existam Outros Instrumentos Direcionados à Mensuraçãounclassified

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Quality of Life in Men Undergoing Prostatectomy: Integrative Review

Izidoro¹,

Vieira²,

Oliveira³

et al. 2017

Psic., Saúde & Doenças

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RESUMO:Este estudo consiste em uma revisão integrativa da literatura com o objetivo de sumarizar as pesquisas produzidas sobre Qualidade de Vida (QV) em homens submetidos à prostatectomia em publicações nacionais e internacionais publicadas de janeiro de 2009 a fevereiro de 2014, nas bases de dados PubMed, SciELO, LILACS e CINAHL. Foram identificados 40 artigos que atendiam aos critérios de inclusão. A análise dos trabalhos permitiu identificar foco principal no caráter físico e sintomatológico em detrimento aos aspectos psicológicos referidos após a cirurgia. Observou-se lacunas no conhecimento produzido, com escassos estudos brasileiros, predomínio de estudos com baixo nível de evidência e reduzido número de estudos com delineamento experimental, raros estudos com enfoque nos aspectos emocionais e ausência de definição do construto utilizado e de dados psicométricos dos instrumentos e escalas utilizadas. Entretanto, foi possível elaborar uma síntese do conhecimento científico acerca da QV em homens prostatectomizados na perspectiva da literatura internacional e nacional, incluindo diversos aspectos que permeiam esta investigação. Palavras-Chave: Qualidade de vida, câncer de próstata, prostatectomia, neoplasias da próstata ______________________________________________________________________ QUALITY OF LIFE IN MEN UNDERGOING PROSTATECTOMY: INTEGRATIVE REVIEWABSTRACT: This study consists of an integrative review of the literature with the aim of summarizing the researches produced on Quality of Life (QoL) in men submitted to prostatectomy in published national and international publications from January 2009 to February 2014 in the PubMed, SciELO, LILACS and CINAHL. We identified 40 articles, which met the pre-established criteria. The analysis of the work allowed to identify main focus on the physical and symptomatological character in detriment to the psychological aspects referenced after the surgery. We observed gaps in the knowledge produced, such as, few Brazilian studies, studies of experimental designs or that demonstrate a greater level of evidence, lack studies with a focus on emotional aspects, absence of the definition of the construct used, lack of psychometric data of the instruments and Scales used and the prevalence of low evidence studies. However, it was possible to elaborate a summary of the scientific knowledge about QoL in  R. 227, s/n -Setor Leste Universitário, Goiânia -GO, 74605-080, Brasil.

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Longitudinal change of comprehensive lower urinary tract symptoms and various types of urinary incontinence during robot‐assisted radical prostatectomy

Fujimura

Igawa

Aizawa

et al. 2019

Neurourology and Urodynamics

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Aims To clarify longitudinal change of lower urinary tract symptoms (LUTS) and various types of urinary incontinence following robot‐assisted radical prostatectomy (RARP) using validated questionnaires. Materials and methods The core lower urinary tract symptom score (CLSS) and the International Consultation on Incontinence Questionnaire (ICIQ)‐Short Form (SF) questionnaires were administered to 607 consecutive, treatment‐naïve men receiving RARP before and after surgery. The time course of comprehensive LUTS and various types of urinary incontinence, including stress‐, urgency‐, and urinary incontinence with no obvious reason, were evaluated. Continence recovery rates were compared for the different types of incontinence using Cox hazard regression analysis. Results After surgery, stress urinary incontinence (SUI) was reported most frequently (32% of cases) as the chief complaint with the most impact on daily life, as assessed by the CLSS questionnaire, followed by urgency urinary incontinence (UUI; 27% of cases). The rates of continence recovery differed among the different types of urinary incontinence, such as after urinating, when dressed, when asleep, when physically active or exercising, when coughing or sneezing, before reaching the toilet, and for no obvious reason. Incontinence for no obvious reason at 1 month after RARP was a strongest prognostic factor of delayed continence recovery (hazard ratio, 0.61; P < 0.0001), whereas patients reporting SUI and UUI gradually regained continence. Conclusions Further time course on continent recovery after RARP would be more precisely predictable based on the incontinence status at one month postoperatively. Especially, incontinence with no obvious reason would be a significant factor for delayed recovery.

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Incontinence After Radical Prostatectomy: A Patient Centered Analysis and Implications for Preoperative Counseling

Abstract: Despite patient concerns of incontinence after prostatectomy they report little interference with quality of life.

Cited by 33 publications

References 16 publications

Impact of preoperative and postoperative membranous urethral length measured by 3 Tesla magnetic resonance imaging on urinary continence recovery after robotic-assisted radical prostatectomy

Impact of preoperative and postoperative membranous urethral length measured by 3 Tesla magnetic resonance imaging on urinary continence recovery after robotic-assisted radical prostatectomy

Quality of Life in Men Undergoing Prostatectomy: Integrative Review

Longitudinal change of comprehensive lower urinary tract symptoms and various types of urinary incontinence during robot‐assisted radical prostatectomy

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