Assessment of early continence recovery after radical prostatectomy: Patient reported symptoms and impairment

S. Kielb*, R. L. Dunn, M. G. Rashid, S. Murray, M. G. Sanda, J. E. Montie, J. T. Wei

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

38 Scopus citations

Abstract

Purpose: Patients considering radical prostatectomy often inquire as to when they can expect to regain urinary continence. However, there is a paucity of patient self-reported data regarding the recovery of continence during the initial 3 months after surgery. Our objectives were to assess urinary continence changes early in the postoperative period and determine which of 2 commonly used definitions of continence more closely relate to patient reported urinary impairment. Materials and Methods: A prospective study of 90 men with clinically localized prostate cancer who selected radical prostatectomy as primary therapy was conducted. Repeated measures of urinary continence as defined by 1) total urinary control, 2) the use of 1 or 0 pads daily, and 3) small or no problem with urinary function were obtained with a brief survey preoperatively and postoperatively. Results: At 56 days after removal of urethral catheters, the actuarial rates of urinary continence recovery based on definitions 1 to 3 were 43%, 84% and 82%, respectively. The use of definition 2 for continence resulted in a 1.9 times higher actuarial rate for continence recovery when compared to definition 1 at 56 days (p <0.001). However, strong agreement was observed between definitions 2 and 3 (κ = 0.69). Conclusions: Urinary control is recovered in a significant proportion of men who undergo radical prostatectomy during the initial 3 months. Continence rates will vary significantly based on the use of alternative definitions. The clinical practice of asking patients how many pads daily they use may be valid, as it corresponds well to the impairment they have.

Original languageEnglish (US)
Pages (from-to)958-961
Number of pages4
JournalJournal of Urology
Volume166
Issue number3
DOIs
StatePublished - 2001

Keywords

  • Outcome assessment (healthcare)
  • Postoperative complications
  • Prostatectomy
  • Prostatic neoplasms
  • Urinary incontinence

ASJC Scopus subject areas

  • Urology

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