title: Utilization of surgical procedures and racial disparity in the treatment of urinary incontinence after prostatectomy.
abstract: To analyze the rates of incontinence procedures after radical prostatectomy, and define the variables associated with them.
  
  
  
  We conducted an IRB approved retrospective review of patients with prostate cancer who underwent radical prostatectomy at a single institute from January 1998 to December 2012. Logistic regression and time to event analyses were performed to ascertain variables associated with receipt of incontinence procedure after prostatectomy.
  
  
  
  Four thousand four hundred one men underwent radical prostatectomy (69.8% open, 30.1% laparoscopic or robotic) of whom 74.3% were white Caucasian and 22.1% were African-American. Overall, 165 (3.7%) patients underwent a total of 191 procedures for male urethral sling or artificial urinary sphincter placement. African-American men received fewer incontinence procedures than white Caucasian men (2.1% versus 4.3%, P = 0.001); and with a longer delay after prostatectomy than white Caucasian men (28.3 months versus 19.9 months, P = 0.029). Men who had a laparoscopic or robotic prostatectomy received an incontinence procedure earlier than men who had an open prostatectomy (17.6 months versus 24.4 months, P = 0.0001). On multivariate analysis, age at prostatectomy, diagnosis of incontinence, and race were independently associated with receiving an incontinence procedure.
  
  
  
  The overall rate of incontinence surgery after radical prostatectomy is low at 3.7%. African-American men receive incontinence procedures at a lower rate and with a longer delay after prostatectomy than white Caucasian men. Further studies are needed to define the reasons for this racial disparity in urinary incontinence surgery in the prostate cancer survivor. Neurourol. Urodynam. 35:733-737, 2016. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Department of Urology, University of Kentucky, Lexington,, Kentucky.
authors.forename: Shubham
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina.
authors.forename: Laura
authors.initials: L
authors.lastname: Ding
authors.affiliation: Division of Urology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Michael
authors.initials: M
authors.lastname: Granieri
authors.affiliation: Division of Urology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Ngoc-Bich
authors.initials: NB
authors.lastname: Le
authors.affiliation: Division of Urology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Peterson
mesh_terms: D001741:Black or African American; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery; D012189:Retrospective Studies; D053825:Suburethral Slings; D061665:Time-to-Treatment; D014549:Urinary Incontinence / Q000209:etiology* / Q000601:surgery*; D016741:Urinary Sphincter, Artificial; D044465:White People
keywords: artificial urinary sphincter; incontinence; male sling; prostate cancer; racial disparity