- Email: [email protected]
Characterization of the “one-pad patient” at long-term follow-up after radical prostatectomy
32nd Annual EAU Congress, 24-28 March 2017, London, United Kingdom
1083
Characterization of the “one-pad patient” at long-term follow-up after radical prostatectomy Eur Urol Suppl 2017; 16(3);e1890
Löppenberg B., Müller G., Bach P., Von Bodman C., Brock M., Roghmann F., Noldus J., Palisaar J. Ruhr-University Bochum, Marien Hospital Herne, Dept. of Urology, Herne, Germany INTRODUCTION & OBJECTIVES: Various definitions of continence after radical prostatectomy for prostate cancer exist. Most authors consider patients who use one pad for security as continent. Others argue, only patients without any pads should considered continent. We sought to evaluate functional outcomes and health-related quality of life (HRQOL) in the “one-pad patient” at long-term follow-up after open retropubic radical prostatectomy (ORRP) in contrast to those patients without pads or ≥2 pads. MATERIAL & METHODS: Patients who underwent ORRP between 2003 and 2010 were followed with standardized questionnaires five years after surgery. The International Consultation on Incontinence Questionnaire (ICIQ), International Prostate Symptom Score (IPSS), European Organization for Research and Treatment of cancer (EORTC) QLQ-C30, EORTC PR-25, and an institutional questionnaire were applied. Patient groups were compared using descriptive, uni- and multivariable analyses to assess impact of pad consumption on functional outcomes and HRQOL. RESULTS: A follow-up was available for 60% (1895/3173) patients. Median follow-up was 60 months (IQR 60, 61). Overall, 69% (1303/1895), 9.6% (182/1895), and 18% (349/1895) used 0, 1, or ≥2 pads. The majority (46% [84/183]) of patients using one pad considered themselves as continent. Total IPSS score was significantly different between those patients using 0, 1, or ≥2 pads (p<0.001). Mean ICIQ score was significantly different between those patients using 0, 1, or ≥2 pads (p<0.001). Of all, 2.3% (4/171) of the patients using one pad achieved total continence in the ICIQ, whereas 51% (81/171) of these patients had severe incontinence according to the ICIQ. The global health score and the social function score of the EORTC QLQ-C30 did not differ clinically significant between those patients using no or one pad (73.9 vs. 69.9 and 82.2 vs. 78.1, respectively). Clinically meaningful differences were observed in the prostate-specific module of the EORTC questionnaire. Concerning urinary function no pad patients showed clinically meaningfully differences compared to those using no pad (24.7 vs. 19.7; p<0.001). Additionally, a large clinically meaningfully difference was observed considering bother induced by use of an incontinence device. Those patients with no pads vs. those with one pad had significantly lower bother induced by use of an incontinence device (12.9 vs. 28.8; p<0.001). CONCLUSIONS: Our results indicate, at long-term follow-up, “one-pad patients” cannot be considered as continent. Patient’s self-estimation, functional and HRQOL questionnaire-based outcomes indicate these patients are incontinent. Functional outcomes of radical prostatectomy should be reported, accordingly.
Eur Urol Suppl 2017; 16(3);e1890 Powered by TCPDF (www.tcpdf.org)
1083
Characterization of the “one-pad patient” at long-term follow-up after radical prostatectomy Eur Urol Suppl 2017; 16(3);e1890
Löppenberg B., Müller G., Bach P., Von Bodman C., Brock M., Roghmann F., Noldus J., Palisaar J. Ruhr-University Bochum, Marien Hospital Herne, Dept. of Urology, Herne, Germany INTRODUCTION & OBJECTIVES: Various definitions of continence after radical prostatectomy for prostate cancer exist. Most authors consider patients who use one pad for security as continent. Others argue, only patients without any pads should considered continent. We sought to evaluate functional outcomes and health-related quality of life (HRQOL) in the “one-pad patient” at long-term follow-up after open retropubic radical prostatectomy (ORRP) in contrast to those patients without pads or ≥2 pads. MATERIAL & METHODS: Patients who underwent ORRP between 2003 and 2010 were followed with standardized questionnaires five years after surgery. The International Consultation on Incontinence Questionnaire (ICIQ), International Prostate Symptom Score (IPSS), European Organization for Research and Treatment of cancer (EORTC) QLQ-C30, EORTC PR-25, and an institutional questionnaire were applied. Patient groups were compared using descriptive, uni- and multivariable analyses to assess impact of pad consumption on functional outcomes and HRQOL. RESULTS: A follow-up was available for 60% (1895/3173) patients. Median follow-up was 60 months (IQR 60, 61). Overall, 69% (1303/1895), 9.6% (182/1895), and 18% (349/1895) used 0, 1, or ≥2 pads. The majority (46% [84/183]) of patients using one pad considered themselves as continent. Total IPSS score was significantly different between those patients using 0, 1, or ≥2 pads (p<0.001). Mean ICIQ score was significantly different between those patients using 0, 1, or ≥2 pads (p<0.001). Of all, 2.3% (4/171) of the patients using one pad achieved total continence in the ICIQ, whereas 51% (81/171) of these patients had severe incontinence according to the ICIQ. The global health score and the social function score of the EORTC QLQ-C30 did not differ clinically significant between those patients using no or one pad (73.9 vs. 69.9 and 82.2 vs. 78.1, respectively). Clinically meaningful differences were observed in the prostate-specific module of the EORTC questionnaire. Concerning urinary function no pad patients showed clinically meaningfully differences compared to those using no pad (24.7 vs. 19.7; p<0.001). Additionally, a large clinically meaningfully difference was observed considering bother induced by use of an incontinence device. Those patients with no pads vs. those with one pad had significantly lower bother induced by use of an incontinence device (12.9 vs. 28.8; p<0.001). CONCLUSIONS: Our results indicate, at long-term follow-up, “one-pad patients” cannot be considered as continent. Patient’s self-estimation, functional and HRQOL questionnaire-based outcomes indicate these patients are incontinent. Functional outcomes of radical prostatectomy should be reported, accordingly.
Eur Urol Suppl 2017; 16(3);e1890 Powered by TCPDF (www.tcpdf.org)