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J Surg Oncol. 2018 Feb;117(2):321-327. doi: 10.1002/jso.24816. Epub 2017 Sep 6.

Nationwide, population-based study of post radical prostatectomy urinary incontinence correction surgery.

Author information

1
Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.
2
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
3
Department of Molecular Medicine and Surgery, Karolinska Institutet, and Department of Urology, Karolinska University Hospital, Stockholm, Sweden.
4
Division of Urological Cancers, Department of Translational Medicine Urology, Lund University, Lund, Sweden.
5
Department of Urology/CamPARI Clinic, Cambridge University Hospitals, Cambridge, UK.
6
Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden.

Abstract

OBJECTIVES:

To assess the use of post radical prostatectomy (RP) urinary incontinence (PPI) surgery and to investigate factors related to its use.

METHODS:

Cohort study in Prostate Cancer database Sweden (PCBaSe) of men who underwent primary RP between 1998 and 2012. PPI correction procedures were identified in the Patient Registry. Hazard ratios (HR) and 95% confidence intervals (CIs) of PPI surgeries were estimated.

RESULTS:

Seven hundred eighty-two out of 26 280 (3%) men underwent PPI surgery at a median time of 3 years after RP. There was an eightfold increase in the absolute number of PPI surgeries during 2000-2014 and a threefold increase in the number per 1000 RPs performed. Factors associated with high use PPI surgery were age >70, HR 1.96 (1.54-2.50), and high hospital RP volume (>100 RPs/year), HR 0.81 (0.66-0.99). There was a 10-fold difference in use of PPI surgery per 1000 RPs between the county with the highest versus lowest use. In a subgroup of men with Patient-Reported Outcome Measures (PROM); severe PPI was reported by 7% of men and 24% of them underwent PPI surgery.

CONCLUSIONS:

Three percent of all men received PPI surgery, with a 10-fold variation among health care providers. Only a quarter of men with severe PPI underwent PPI surgery, suggesting that PPI surgery remains underutilized.

KEYWORDS:

PROM; artificial urinary sphincter; population based; post radical prostatectomy urinary incontinence

PMID:
28876467
PMCID:
PMC5873254
DOI:
10.1002/jso.24816
[Indexed for MEDLINE]
Free PMC Article

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