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)

Abstract

Aims: To identify the definition for urinary continence (UC) after radical prostatectomy (RP) which reflects best patients' perception of quality of life (QoL). Methods: Continence was prospectively assessed in 634 patients, 12 months after RP using the International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) and the number of pads employed in a 24-hour period (pad usage). We used the one-way ANOVA technique with posthoc pairwise comparisons according to Scheffé's method (homogeneous subsets) for assessing the degree of QoL deficit related to urinary incontinence (UI). Results: The continence prevalence is 64.4%, 74.1%, 88.3%, and 35.8% using "0 pads," "1 safety pad," "1 pad," and "ICIQ score 0" definitions, respectively. Pad usage is moderately strongly associated with ICIQ 1, 2, and 3 (ρ = 0.744, 0.677, and 0.711, respectively; p < 0.001). Concordance between classical UC definitions is acceptable between "0 pads-ICIQ score 0" (K = 0.466), but poor for "1 safety pad" and "1 pad" (K = 0.326 and 0.137, respectively). Patients with "0 pad usage" have better QoL related to urine leakage than patients with "1 safety pad" or "1 pad" (1.41 vs. 2.44 and 3.11, respectively; p < 0.05). There were no significant differences found regarding QoL between patients with ICIQ score 0 and ICIQ score 2 (1.01 vs. 1.63; p = 0.63). Conclusions: Pad usage and the ICIQ-SF's answers provide useful information. We propose a combined definition (0 pads and ICIQ score ≤2) as it is the definition with the least impact on daily QoL.

Longitudinal, 5‐year long‐term outcomes for urinary continence and quality of life after robot‐assisted radical prostatectomy in Japanese patients

“…As for the assessment of UC after RARP, a recent report that assessed the ICIQ‐SF score and number of pads used reported that QOL did not differ between ICIQ‐SF scores of 0 and 2 or less 22 . In this study, although the ICIQ‐SF total score was higher than the preoperative score, the median score in the NS and NNS groups at 60 months postoperatively was 2; therefore, UI may not be severe enough to impair QOL significantly.…”

The Virtue quadratic male sling for postradical prostatectomy urinary incontinence: 3‐Year outcome measurements and a predictive model of surgical outcome from a European prospective observational study

“…Nine (7.7%) cases of urinary retention occurred within the first postoperative day after catheter removal. Two cases required no treatment and the seven‐other resolved with urethral catheterization and a successful voiding trial within an average of 4, 5 days 1–13 . No patients had persistent high PVR volume requiring revision of the sling.…”

“…Most of them (90.4%) were expected from a normal postoperative courses or Clavien–Dindo Grade I. Five remaining cases required gamma‐aminobutyric acid analogs, 2 peripheral nerve blocks by botox injection, 2 and partial resection of the sling 1 . One patient had a urinary tract infection within the first month after implantation of the sling.…”

“…Two cases required no treatment and the seven-other resolved with urethral catheterization and a successful voiding trial within an average of 4, 5 days. [1][2][3][4][5][6][7][8][9][10][11][12][13] No patients had persistent high PVR volume requiring revision of the sling.…”

“…Five remaining cases required gamma-aminobutyric acid analogs, 2 peripheral nerve blocks by botox injection, 2 and partial resection of the sling. 1 One patient had a urinary tract infection within the first month after implantation of the sling. Eight patients with postoperative de novo urge incontinence received anticholinergics medication for several months.…”