Urinary Incontinence, Patient Satisfaction, and Decisional Regret after Prostate Cancer Treatment: A French National Study

Abstract

Background: Complications of prostate cancer treatments have a substantial impact on the patient’s quality of life. We evaluated the prevalence of urinary consequences and factors affecting patient satisfaction and decisional regret after treatment. Methods: A retrospective self-administered questionnaire was sent to all members of the National Association of Prostate Cancer Patients in France. Results: From the 226 completed questionnaires received, the following information was obtained: 110 patients underwent surgery only, 29 received radiotherapy plus hormone therapy, 28 received radiotherapy only, and 49 received other combination treatments. The median follow-up period was 58.1 months. After treatment, the presence of urinary incontinence was reported by 34.5% of patients treated by radical prostatectomy, by 10.3% treated by radiotherapy plus hormone therapy, by 17.8% treated by curitherapy or radiotherapy only, and by 38.7% treated by other combination therapy (p = 0.01). The main reasons for decisional regret were the fact that patients received incomplete information about prostate cancer (40%) and consequences of treatment that affected the urinary system (34%). The information received about cancer was considered complete in 32.3% of the satisfied group and 14.3% of the decisional regret group (p = 0.003) and with regard to urinary incontinence the information received was considered complete in 41.4 and 17.4% respectively (p < 0.01). Conclusions: Urinary consequences of prostate cancer treatment are common and impact the quality of life. Patients need clear information to be able to participate in therapeutic decision-making and to avoid subsequent decisional regret.

Influences of Surgical Volume on Perioperative and Oncological Outcomes Following Radical Prostatectomy

“…Functional outcomes like potency and urinary continence are very important parameters for patients undergoing prostate cancer treatment and the occurrence of urinary incontinence is usually higher after surgery compared to other treatment options [20]. It would be of great interest if a high volume of radical prostatectomies in one centre is related to a better functional outcome compared to centres with a lower volume.…”

Prediction of Complications in Radical Prostatectomy Prostate Cancer Patients: Simulated Annealing versus Co-Morbidity Indexes

“…Regarding conditions predicting 90-day medical complications, we identified a number of well-established comorbidities such as hypertension, chest pain, congestive heart failure and chronic airway obstruction [4]. Besides DOI: 10.1159/000495071 these, we also identified brachial neuritis/radiculitis, which represents a less well-known risk factor for postoperative medical complications after RP.…”

“…Similar to the comorbidities for 90-day medical complications, these conditions were derived from pre-existing co-morbidities and reflect the co-morbidity profile of contemporary men treated with RP for clinically localized PCa. Their nature ranges from coronary artery atherosclerosis through anaemia and hyperglyceridemia, to hypotension and genitourinary problems [4].…”

“…However, particularly RP is under increasing scrutiny of functional outcomes [4] including peri-and post-operative complications due to increasing use of alternative, less invasive treatment modalities, such as active surveillance [5].…”

Development and randomised controlled trial of a Continence Product Patient Decision Aid for men postradical prostatectomy

“…A common side effect of surgery is the sudden onset of urinary incontinence (Daugherty et al, 2017; Haglind et al, 2015) and, when this happens, adequate containment of leakage is fundamental to health and quality of life. Urinary incontinence can have a profoundly negative effect on men's quality of life, including increasing the risk of anxiety or depression (Köhler et al, 2014) or decisional regret on choice of treatment (Albkri et al, 2017). Poorly contained leakage causes considerable harm, for example increasing social isolation (Braaf, Lennox, Nunn, & Gabbe, 2017; Keighley et al, 2016), burden on carers (Santini, Andersson, & Lamura, 2015), risk of falls (Noguchi et al, 2016), likelihood of care home admission (Morrison & Levy, 2006) and damage to skin (Beeckman, 2017).…”