Continence assessment after radical prostatectomy
Article published in Urologia Polska 2008/61/Supl. 1.

authors

Roman Sosnowski, Tomasz Demkow, Tomasz Kalinowski, Tomasz Chwaliński, Adam Zakościelny, Anna Rosa, Hanna Tchórzewska, Wojciech Michalski

Klinika Nowotworów Układu Moczowego, Centrum Onkologii w Warszawie
Zakład Rehabilitacji, Centrum Onkologii w Warszawie
Biuro Badań Klinicznych i Biostatystyki, Centrum Onkologii w Warszawie

summary

Introduction.

Due to increase in incidence of organ confined prostate cancer (PC) there is a significant increase in number of performed radical prostatectomies (RP). Despite in advances in surgical techniques and minimally invasive techniques incontinence after the surgery still remains significant complication.

Objectives.

The study was aimed at assessing the continence after radical prostatectomy.

Materials and methods.

Prospective analysis of continence in 70 patients after RP was performed using the ICI-Q questionnaire (points 1 to 3 – quality of continence and point 4 – assessment of factors resulting in incontinence). Prostatectomies were performed by 5 experienced surgeons. The analysis was performed before the surgery, 6 weeks, 3, 6 and 12 months after the surgery. Additionally factors like: disease stage, surgical margins status and adjuvant radiotherapy were also taken into account. Analysis was performed using general linear model for ICI-Q questionnaire analysis (sum of questionnaire points) for correlation with time and prognostic factors.

Results.

Replies were obtained from 55 patients with PSA prior to surgery within the range 1.1 to 17 ng/ml. (median 6.6). Gleason score was 3 to 8 (median 6). 5 patients received adjuvant radiotherapy. Priori to surgery 95% of patients were fully continent. After 12 months post surgery 83% of the patients had satisfactory continence, in that 28% were fully continent. 17% remaining patients had mild incontinence, no patient had complete incontinence. Coughing and sneezing were the most frequent reasons for incontinence (33% of the cases), as well as physical activity (50%). There is a linear negative correlation (decrease in time) between questionnaire points, which corresponds to improvement in continence, in the following time points (p<0.001). There was no statistically significant correlation between the questionnaire points and analysed prognostic factors.

Conclusions.

sPR significantly influences continence. Significant improvement in continence quality in time after PR has significant impact on return to normal functioning.