title: Incontinence after radical prostatectomy: a patient centered analysis and implications for preoperative counseling.
abstract: OBJECTIVE
  Incontinence after radical prostatectomy is common yet poorly defined in the current literature. We aimed to accurately characterize incontinence after robot-assisted radical prostatectomy to achieve improved preoperative patient counseling.
  
  
  METHODS
  After receiving institutional review board approval we performed a cross-sectional survey of the first 600 patients with prostate cancer who underwent robot-assisted radical prostatectomy at our institution. The International Consultation on Incontinence Modular Questionnaire-Lower Urinary Tract Symptoms Quality of Life and Urinary Incontinence Short Form were used to evaluate incontinence and quality of life after robot-assisted radical prostatectomy. Surveys were mailed by a third party. Data were analyzed on the prevalence of incontinence after robot-assisted radical prostatectomy. More specifically we characterized in detail the nature of incontinence and its effect on quality of life.
  
  
  RESULTS
  The response rate was 68% (408 of 600 participants). Response time since surgery was 2.5 months to 4 years. Overall incontinence bother scores and ratings of life interference were quite low. Patients reported that most incontinence occurred during physical activity but 35% reported interference with sleep. Of the patients 31% experienced some anxiety due to urinary difficulties and 51% had to occasionally change clothes due to leakage. Patients did not report much interference with traveling, visiting friends or family and family life. The most bothersome aspects of incontinence were its effects on partner relationship, sexual life and energy levels.
  
  
  CONCLUSIONS
  Despite patient concerns of incontinence after prostatectomy they report little interference with quality of life.
authors.affiliation: Mayo Clinic, Phoenix, Arizona, USA. Martin.aaron@mayo.edu
authors.forename: Aaron D
authors.initials: AD
authors.lastname: Martin
authors.forename: Leah Y
authors.initials: LY
authors.lastname: Nakamura
authors.forename: Rafael N
authors.initials: RN
authors.lastname: Nunez
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Wolter
authors.forename: Mitchell R
authors.initials: MR
authors.lastname: Humphreys
authors.forename: Erik P
authors.initials: EP
authors.lastname: Castle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D037001:Directive Counseling; D006801:Humans; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care; D057234:Preoperative Period; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D011788:Quality of Life; D012371:Robotics; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000209:etiology*