Abstract
Purpose
To examine outcomes of surgical procedures for urinary incontinence after radical prostatectomy (post-RP UI) and to identify patients who may benefit from a surgical intervention to treat post-RP UI.
Methods
A retrospective chart review identified men who underwent radical prostatectomy (RP) from July 2004 through July 2016 at our institution. Cases underwent surgical interventions for UI following RP. Controls had RP during the study period but did not have an intervention for UI following RP. We used the UI scale of the Expanded Prostate Index Composite (EPIC) 26 to: (1) quantify post-RP UI before and after UI intervention overall and for specific surgical procedures; (2) evaluate the significance of improvement in post-RP UI before and after UI intervention and (3) identify controls with levels of post-RP UI that were comparable to the cases.
Results
Two thousand nine hundred and sixty-eight RPs were performed; 48 patients underwent further surgical intervention (39 slings, 9 artificial urinary sphincter, AUS). For 20 cases with complete EPIC UI data (15 slings, 5 AUS), the median (IQR) pre-UI intervention score was 27.00 (IQR 22.75–42.75). Improvement was significant overall (p < 0.001) and for slings (p = 0.001). 71/2085 controls had post-prostatectomy UI scores ≤ 27.0, suggesting that they may have benefited from a post-RP surgical intervention for UI.
Conclusion
Data support the effectiveness of surgery to treat post-RP UI. A sizeable population of unidentified men may benefit from a surgical intervention to treat urinary incontinence after RP.
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Data availability
Sharing of de-identified data with an external entity would require the approval of the Hartford Hospital IRB.
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Funding
This project did not receive financial support.
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Conceptualization: SA, RK, IS, TM, JT, JW. Data collection and management: SA, JT. Formal analysis and investigation: IS. Writing—original draft preparation: SA, IS, TM, JW. Writing—review and editing: SA, RK, IS, TM, JT, JW. Supervision: JW.
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JW serves on the speaker’s bureau for Genomic Health and as a consultant for Covidien.
Ethics approval
This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Hartford Hospital Institutional Review Board (IRB) approved this study.
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The Hartford Hospital Institutional Review Board approved this study with a full waiver of consent.
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Alam, S., Kershen, R., Staff, I. et al. Use of EPIC 26 to identify men likely to benefit from surgical interventions for urinary incontinence after radical prostatectomy. World J Urol 39, 1439–1443 (2021). https://doi.org/10.1007/s00345-020-03325-6
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DOI: https://doi.org/10.1007/s00345-020-03325-6