Risk of Urinary Incontinence Following Prostatectomy: The Role of Physical Activity and Obesity

Abstract

Purpose Urinary incontinence is one of the most commonly reported and distressing side effects of radical prostatectomy for prostate carcinoma. Several studies have suggested that symptoms may be worse in obese men but to our knowledge no research has addressed the joint effects of obesity and a sedentary lifestyle. We evaluated the association of obesity and lack of physical activity with urinary incontinence in a sample of men who had undergone radical prostatectomy. Materials and Methods Height and weight were abstracted from charts, and obesity was defined as body mass index 30 kg/m2 or greater. Men completed a questionnaire before surgery that included self-report of vigorous physical activity. Men who reported 1 hour or more per week of vigorous activities were considered physically active. Men reported their incontinence to the surgeon at their urology visits. Information on incontinence was abstracted from charts at 6 and 58 weeks after surgery. Results At 6 weeks after surgery 59% (405) of men were incontinent, defined as any pad use. At 58 weeks after surgery 22% (165) of men were incontinent. At 58 weeks incontinence was more prevalent in men who were obese and physically inactive (59% incontinent). Physical activity may offset some of the negative consequences of being obese because the prevalence of incontinence at 58 weeks was similar in the obese and active (25% incontinent), and nonbese and inactive (24% incontinent) men. The best outcomes were in men who were nonobese and physically active (16% incontinent). Men who were not obese and were active were 26% less likely to be incontinent than men who were obese and inactive (RR 0.74, 95% CI 0.52–1.06). Conclusions Pre-prostatectomy physical activity and obesity may be important factors in post-prostatectomy continence levels. Interventions aimed at increasing physical activity and decreasing weight in patients with prostate cancer may improve quality of life by offsetting the negative side effects of treatment.

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“…Age, as the most observed risk factor of incontinence after prostatectomy (14,15), was also confirmed in our patient's group, while older age reduced the achievement of continence (HR=0.932, 95%CI=0.893-0.973). This may be related to the condition that, as with other muscles, the sphincter muscle deteriorates with age.…”

The prevalence of urinary incontinence and its burden on the quality of life among older adults with medicare supplement insurance

“…Specifically, some health conditions and treatments (e.g. prostate cancer, cancer treatment, prostate procedures, childbirth, hysterectomy, and medications) often increase the risk of UI [7,[23][24][25]. Although most of these were not measured in the HUS, respondents with prostate cancer could be identified.…”

Robot-assisted prostatectomy: the new standard of care

“…However, the compared collective are only matched for age and oncologic parameters. As there is evidence for different parameters of patient's impact on continence outcome like diabetes mellitus, obesity, patient's activity, marital status, income, and others, these factors should also be considered when matching patients [3,58,59]. Anyhow, there is a difference in preserving erectile function.…”

“…Among non-obese patients, those with reported activity had also better outcome than there non-active counterparts. The authors could therefore identify obesity and patient's activity as independent parameters for the risk of being incontinent after radical prostatectomy [58]. Obese and inactive patients often have co-morbidity like diabetes mellitus.…”