title: Long-term continence outcomes in men undergoing radical prostatectomy for clinically localized prostate cancer.
abstract: BACKGROUND
  Urinary incontinence is a common short-term complication of radical prostatectomy (RP). Little is known about the long-term impact of RP on continence.
  
  
  OBJECTIVE
  To elucidate the long-term progression of continence after RP.
  
  
  METHODS
  From October 2000 through September 2012, 1788 men undergoing open RP for clinically localized prostate cancer by a single surgeon at an urban tertiary care center prospectively signed consent to be followed before RP and at 3, 6, 12, 24, 96, and 120 mo after RP. A consecutive sampling method was used and all men were included in this study.
  
  
  METHODS
  Men underwent open RP.
  
  
  METHODS
  Regression models controlled for preoperative University of California, Los Angeles-Prostate Cancer Index urinary function score (UCLA-PCI-UFS), age, prostate-specific antigen level, Gleason score, stage, nerve-sparing status, race, and marital status were used to evaluate the association of time since RP with two dependent variables: UCLA-PCI-UFS and continence status.
  
  
  RESULTS
  The mean UCLA-PCI-UFS declined between 2 yr and 8 yr (83.8 vs 81.8; p=0.007) and marginally between 8 yr and 10 yr (81.8 vs 79.6; p=0.036) after RP, whereas continence rate did not significantly change during these intervals. Men ≥ 60 yr old experienced a decline in mean UCLA-PCI-UFS between 2 yr and 8 yr (p=0.002) and a marginal decline in continence rate between 2 yr and 10 yr (p=0.047), whereas these variables did not change significantly in men <60 yr old. These outcomes are for an experienced surgeon, so caution should be exercised in generalizing these results.
  
  
  CONCLUSIONS
  Between 2 yr and 10 yr after RP, there were slight decreases in mean UCLA-PCI-UFS and continence rates in this study. Men aged <60 yr had better long-term outcomes. These results provide realistic long-term continence expectations for men undergoing RP.
authors: Department of Urology, New York University School of Medicine, New York, NY, USA.
authors: Vinay
authors: V
authors: Prabhu
authors: Ganesh
authors: G
authors: Sivarajan
authors: Glen B
authors: GB
authors: Taksler
authors: Juliana
authors: J
authors: Laze
authors: Herbert
authors: H
authors: Lepor
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D011471:Prostatic Neoplasms / Q000601:surgery*; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology*
keywords: Incontinence; Outcomes; Prostate cancer; Prostatectomy; Quality of life
references: J Clin Oncol. 2005 Apr 20;23(12):2772-80
references: 15837992
references: J Urol. 2000 Sep;164(3 Pt 1):744-8
references: 10953138
references: J Urol. 2004 Mar;171(3):1212-5
references: 14767304
references: J Urol. 2004 Dec;172(6 Pt 1):2227-31
references: 15538237
references: N Engl J Med. 2013 Jan 31;368(5):436-45
references: 23363497
references: Med Care. 1998 Jul;36(7):1002-12
references: 9674618
references: J Urol. 1998 Jun;159(6):1988-92
references: 9598504
references: BJU Int. 2011 Feb;107(4):585-90
references: 20804482
references: J Urol. 2005 May;173(5):1701-5
references: 15821561
references: Eur Urol. 2012 Sep;62(3):368-81
references: 22763081
references: Urology. 2010 Nov;76(5):1231-8
references: 20579698
references: J Urol. 2010 Mar;183(3):871-7
references: 20083262
references: N Engl J Med. 2008 Mar 20;358(12):1250-61
references: 18354103
references: Cancer. 2007 May 1;109(9):1769-76
references: 17380491
references: J Urol. 2009 Feb;181(2):731-5
references: 19091349
references: CA Cancer J Clin. 2012 Jul-Aug;62(4):220-41
references: 22700443
references: Urology. 2007 Dec;70(6):1127-30
references: 18158032
references: JAMA. 2000 Jan 19;283(3):354-60
references: 10647798
references: J Clin Oncol. 2010 Mar 1;28(7):1117-23
references: 20124165
references: J Natl Cancer Inst. 2009 Jun 16;101(12):888-92
references: 19509365
references: J Urol. 2010 Nov;184(5):1977-81
references: 20850836
references: J Urol. 2008 May;179(5 Suppl):S40-4
references: 18405749
references: Eur Urol. 2012 Sep;62(3):405-17
references: 22749852
references: J Clin Oncol. 2007 Aug 20;25(24):3576-81
references: 17704404
references: Eur Urol. 2012 Jul;62(1):42-52
references: 22421080
references: J Urol. 2004 Mar;171(3):1216-9
references: 14767305
references: Urology. 2000 Jan;55(1):58-61
references: 10654895
references: J Clin Oncol. 2010 Nov 1;28(31):4687-96
references: 20921463
references: J Urol. 2010 Jun;183(6):2206-12
references: 20399462
references: BJU Int. 2006 Jun;97(6):1234-41
references: 16686718