title: Early continence in patients with localized prostate cancer. A comparison between open retropubic (RRPE) and endoscopic extraperitoneal radical prostatectomy (EERPE).
abstract: OBJECTIVE
  The study examined and compared continence rates in prostate cancer patients who had undergone either open retropubic prostatectomy (RRPE) or endoscopic extraperitoneal radical prostatectomy (EERPE). The core question was whether the surgical approach had an effect on the patients' continence status 3 months after surgery.
  
  
  METHODS
  We conducted a multicentric, longitudinal study in 7 German hospitals. Three hundred fifty prostate cancer patients (166 EERPE, 184 RRPE) were asked to self-assess symptoms associated with urinary incontinence (UI) 1 day before and 3 months after prostatectomy. Symptoms of UI were assessed using the EORTC QLQ-PR25 questionnaire. Urinary continence was defined according to (1) the use of no protective pad, (2) the use of up to a single protective pad in a 24-hour period, and (3) according to the patient's self-assessment. A binary regression model was employed to predict early continence status.
  
  
  RESULTS
  Three months after prostatectomy, 44% of patients who underwent EERPE and 40% of patients who underwent RRPE were completely continent. Patients who underwent nerve-sparing prostatectomy and patients younger than 65 years had a better chance of regaining urinary continence earlier. The surgical approach had no significant impact on the patients' continence status. Limitations of the study are a drop-out rate of 39% and sociodemographic and clinical differences between both treatment groups.
  
  
  CONCLUSIONS
  Three months after prostatectomy, there were no significant differences between both treatment groups regarding urinary continence. The surgical approach had no significant effect on the patients' continence status. Higher age and non-nerve-sparing surgery are associated with a longer period of convalescence.
authors: Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany. Norbert.Koehler@medizin.uni-leipzig.de
authors: Norbert
authors: N
authors: Koehler
authors: Lutz
authors: L
authors: Gansera
authors: Jens-Uwe
authors: JU
authors: Stolzenburg
authors: Udo
authors: U
authors: Rebmann
authors: Michael C
authors: MC
authors: Truss
authors: Stephan
authors: S
authors: Roth
authors: Hans-Joerg
authors: HJ
authors: Scholz
authors: Dirk
authors: D
authors: Fahlenkamp
authors: Ralf
authors: R
authors: Thiel
authors: Evangelos
authors: E
authors: Liatsikos
authors: Elmar
authors: E
authors: Braehler
authors: Sigrun
authors: S
authors: Holze
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000009:adverse effects*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011183:Postoperative Complications / Q000453:epidemiology*; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012647:Self-Assessment; D014549:Urinary Incontinence / Q000453:epidemiology*; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects