Late urinary morbidity and quality of life after radical prostatectomy and salvage radiotherapy for prostate cancer

Ervandian, Maria; Høyer, Morten; Petersen, Steffen; Sengeløv, Lisa; Hansen, Steinbjørn; Kempel, M.M.; Petersen, Peter Meidahl; Borre, Michael

doi:10.1080/21681805.2017.1354314

Cited by 8 publications

(10 citation statements)

References 31 publications

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“…An odds ratio of 1.6 for urinary incontinence has been reported for the combination compared to surgery alone 15 . A limitation of most studies is that urinary incontinence was reported by the number of pads used in 24 hours rather than a comprehensive patient reported domain for urinary incontinence [14][15][16] . In particular, no other study compared quality of life outcomes of surgery with adjuvant/salvage radiation versus primary radiation therapy with or without androgen deprivation therapy.…”

Section: Discussionmentioning

confidence: 99%

Patient Reported Urinary Incontinence and Sexual Impotency Following Multimodality Radical Therapy for Prostate Cancer: An Untold Story of Compound Toxicity?

Haisraely¹,

Lawrence²,

Lewin³

et al. 2021

Preprint

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Purpose: To evaluate urinary continence and sexual potency following radical prostatectomy and adjuvant radiotherapy. Materials/Methods: Expanded Prostate Cancer Index Composite (EPIC) surveys of patients with localized prostate cancer treated with surgery followed by adjuvant/salvage pelvic radiotherapy (S+RT) were analyzed. A control cohort was primary radiotherapy (RT). Results: Surveys at least 1 year after treatment were available for 130 S+RT and 374 RT patients. For S+RT vs. RT, the mean urinary incontinence score was 68 [6.25 -100] versus 86.4 [CI-95 39.5-100] (p<0.001), confirming 6.5 points of clinically significant difference. The adjusted odds ratio for superior urinary function was 2.67 (1.7-4.1, p<0.001) for primary radiotherapy. The odds ratio of having both poor urinary and sexual performance was 0.29 in RT arm (0.14-0.58, p<0.001) when adjusted to age and ADT use, group risk stratification, co morbidities and smoking status. Conclusion: In this cross sectional study, Surgery with adjuvant/salvage RT was associated with significantly worse patient reported urinary continence outcomes at 1-year post treatment, lower odds of achieving perfect urinary continence and a threefold risk of reverse ‘bifecta’ with inferior urinary continence and sexual performance. Longitudinal studies of evolving toxicity are required to validate these findings.

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Section: Discussionmentioning

confidence: 99%

Patient Reported Urinary Incontinence and Sexual Impotency Following Multimodality Radical Therapy for Prostate Cancer: An Untold Story of Compound Toxicity?

Haisraely¹,

Lawrence²,

Lewin³

et al. 2021

Preprint

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“…All studies examined OAB symptoms, urge incontinence, urgency, frequency, nocturia, and/or storage symptoms as an outcome measure. A variety of measurements were used across studies, including: clinical assessments; 26 urodynamic examination; 40 27,28,30,43 and a variety of validated questionnaires, including the IPSS, 29,32,33,39,41 DAN-PSS, 31 EORTC, 32,36,42 ICS questionnaire, 32 S-IPSS, 34 OABSS, 34 N-QOL, 35 AUASI, 37 and the Bristol-LUTS questionnaire. 38…”

Section: Lutsmentioning

confidence: 99%

“…38 Prevalence of specific OAB-related symptoms following radical prostatectomy Three studies evaluated the prevalence of urge incontinence following RP, which ranged from 3.2% to 27.3%. 28,31,40 One study observed the prevalence of frequency symptoms following RP of 8.5%. 31 Two studies observed the prevalence of urgency symptoms following RP ranging from 15% to 27%.…”

Section: Radical Prostatectomymentioning

confidence: 99%

“…28,31,40 One study observed the prevalence of frequency symptoms following RP of 8.5%. 31 Two studies observed the prevalence of urgency symptoms following RP ranging from 15% to 27%. 31,43 Three studies observed the prevalence of nocturia symptoms following RP ranging from 9% to 49%.…”

Section: Radical Prostatectomymentioning

confidence: 99%

“…31 Two studies observed the prevalence of urgency symptoms following RP ranging from 15% to 27%. 31,43 Three studies observed the prevalence of nocturia symptoms following RP ranging from 9% to 49%. 31,35,43 Prevalence of general OAB/storage symptoms following radical prostatectomy Three studies examined the prevalence of OAB/storage symptoms, or its burden, following RP.…”

Section: Radical Prostatectomymentioning

confidence: 99%

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The relationship between overactive bladder and prostate cancer: A scoping review

Khan

Crump

Carlson

et al. 2021

CUAJ

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Introduction: The relationship between prostate cancer (PCa) and overactive bladder (OAB) is poorly understood. PCa and OAB are frequently diagnosed in elderly populations, so it could be expected that both conditions would be observed in older patients. Whether PCa and OAB occur independently with age, or the presence of PCa leads to the onset of OAB/lower urinary tract symptoms (LUTS) has not been explored. This review aimed to investigate whether men newly diagnosed with prostate cancer (PCa) are more likely to have overactive bladder (OAB) compared to the general population, and if the various treatment modalities for PCa are likely to impact the incidence or exacerbation of OAB. Methods: The University of Calgary’s databases for Medline and PubMed were searched for relevant publications. No restrictions were placed on the study design reported. Any publications reporting OAB and a PCa diagnosis and/or observation relating to PCa diagnosis and rates of OAB/LUTS in an adult population were included for full review. Results: Of the studies examining the relationship between PCa and LUTS, results varied, but frequently indicated an inverse association between PCa and LUTS in which patients newly diagnosed with prostate cancer were more unlikely to have LUTS compared to the general population. Following treatment, brachytherapy resulted in a higher prevalence of OAB symptoms compared to surgical treatment and external beam radiation therapy. Conclusions: Diverse evidence was found regarding the relationship between the prevalence of pre-treatment OAB and PCa diagnosis. However, limited evidence, as well as uncertainty regarding pre-treatment symptoms and their impact on post-treatment outcomes, restricts potential conclusions.

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How older men live with stress urinary incontinence: Patient experience and navigation to treatment

Shaw,

Breyer,

Walter

et al. 2023

Neurourology and Urodynamics

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ObjectivesTo explore the context in which older men navigate treatment for stress urinary incontinence (SUI) following prostate surgery by characterizing lived experience of men with symptomatic SUI.Subjects/Patients and MethodsMixed method study using surveys and semistructured interviews to examine a cohort of men who underwent evaluation for treatment of postprostatectomy SUI.ResultsThirty‐six men were interviewed after consultation for SUI and 31 had complete quantitative clinical data. Twenty‐six underwent surgery and 10 chose no surgical intervention. In qualitative interviews, respondents experienced substantial decline in quality of life due to incontinence citing concerns associated with use of pads and worrying about incontinence. Most patients reported “workarounds”—efforts to mitigate or manage incontinence including Kegels, physical therapy, and garments. Participants also reported lifestyle changes including less strenuous physical activity, less sexual activity, and/or fewer social gatherings. Patients then described a “breaking point” where incontinence workarounds were no longer sufficient. After seeking evaluation, men described challenges in exploring treatment for SUI, including access to care and provider knowledge of treatment options.ConclusionIn a novel study of patients living with SUI a predictable lived experience was observed that culminated in a desire for change or “breaking point.” In all men, this led to treatment‐seeking behaviors and for many it led to SUI intervention. Despite effective treatments, patients continue to meet barriers gaining access to SUI evaluation and treatment.

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Late urinary morbidity and quality of life after radical prostatectomy and salvage radiotherapy for prostate cancer

Abstract: Patients treated with SRT have a higher rate of urinary morbidity than do patients treated with RP alone. Severe urinary morbidity was significantly related to decreased QoL, but did not differ between the two treatment groups.

Cited by 8 publications

References 31 publications

Patient Reported Urinary Incontinence and Sexual Impotency Following Multimodality Radical Therapy for Prostate Cancer: An Untold Story of Compound Toxicity?

Patient Reported Urinary Incontinence and Sexual Impotency Following Multimodality Radical Therapy for Prostate Cancer: An Untold Story of Compound Toxicity?

The relationship between overactive bladder and prostate cancer: A scoping review

How older men live with stress urinary incontinence: Patient experience and navigation to treatment

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