A prospective study of patient reported urinary incontinence among American, Norwegian and Spanish men 1 year after prostatectomy

• Main Authors: Anne Holck Storås, Martin G. Sanda, Olatz Garin, Peter Chang, Dattatraya Patil, Catrina Crociani, Jose Francisco Suarez, Milada Cvancarova, Jon Håvard Loge, Sophie D. Fosså
• Format: Article
• Language: English
• Published: Elsevier 2020-04-01
• Series: Asian Journal of Urology
• Online Access: http://www.sciencedirect.com/science/article/pii/S2214388219300803

Objective: To compare pre- and post-radical prostatectomy (RP) responses in the urinary incontinence domain of Expanded Prostate Cancer Index Composite-26 (EPIC-26) in cohorts from the USA, Norway and Spain. Methods: A prospective study of pre- and 1-year post-treatment responses in American (n=537), Norwegian (n=520) and Spanish (n=111) patients, establishing the prevalence of urinary incontinence defined according to published dichotomization. Thereafter we focused on the response alternatives “occasional dribbling”, pad use and problem experience. A multivariate logistic regression analysis (significance level ≤ 0.01) considered risk factors for “not retaining total control”. Results: Compared to the European men, the American patients were younger, healthier and more presented with lower risk tumors. Before RP no inter-country differences emerged the prevalence of urinary incontinence (6%). One-year post-treatment urinary incontinence was described by 30% of the American and 41% of the European patients, occasional dribbling being the most frequent type of urinary leakage. In the multivariate analysis the risk of “not retaining total control” increased almost 3-fold in European compared to American patients, with age and co-morbidity being additional independent risk factor. Conclusion: After RP patients from Spain and Norway reported more unfavorable outcomes by EPIC-26 than the American patients to most of the urinary incontinence items, the difference between the European and American patients remaining in the multivariate analysis. The most frequent post-RP response alternative “occasional dribbling” needs to be validated with pad weighing as “gold standard”. Keywords: Prostate cancer, Radical prostatectomy, Urinary incontinence, Adverse effects