| The effect of nerve-sparing surgery on patient-reported continence post-radical prostatectomy. | |
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MedLine Citation:
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PMID: 20019974 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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INTRODUCTION: Urinary continence significantly affects quality of life after radical prostatectomy (RP). The impact of nerve-sparing surgery on continence is unclear from the current literature. METHODS: We identified men with prostate cancer from the University Health Network Prostate Centre database who underwent RP. Preoperatively and at each postoperative visit, patients completed the Patient-Oriented Prostate Utility Scale (PORPUS), a validated psychometric and health utility instrument. Incontinence was defined by a single questionnaire item. Patients with radiotherapy or less than 10 months follow-up were excluded. Chi-squared tests and ANOVA were used to compare groups. Multivariable logistic regression was used to control for effects of nerve-sparing and other covariates. RESULTS: Of the 253 eligible patients from 2003 to 2007, 159 patients had bilateral nerve-sparing, 32 had unilateral nerve-sparing and 62 had non-nerve-sparing surgery. Of these patients, 27%, 17% and 34%, respectively, were classified as incontinent at 1 year. These proportions were not significantly different between groups (p = 0.23). Multivariable logistic regression showed baseline urinary continence and urinary frequency to be significant predictors of patient-reported continence at 1 year postoperatively, with odds ratios of 1.7 (95% confidence interval [CI] 1.1-2.9) and 1.5 (95% CI 1.0-2.3), respectively. There was a significant difference in the proportion of PORPUS sexual function scores between nerve-sparing groups after excluding those with baseline sexual dysfunction (p = 0.003). Similarly, health-related utility scores were different across groups (p < 0.001). CONCLUSION: Our results do not suggest a difference in 1-year patient-reported continence based on the type of nerve-sparing RP. However, baseline continence and urinary frequency were significant predictors of continence at 1 year. |
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Authors:
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Paul Toren; Shabbir M H Alibhai; Andre Matthew; Michael Nesbitt; Robin Kalnin; Neil Fleshner; John Trachtenberg |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Canadian Urological Association journal = Journal de l'Association des urologues du Canada Volume: 3 ISSN: 1911-6470 ISO Abbreviation: Can Urol Assoc J Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2009-12-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101312644 Medline TA: Can Urol Assoc J Country: Canada |
Other Details:
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Languages: eng Pagination: 465-70 Citation Subset: - |
Affiliation:
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Department of Surgery, University of Toronto; |
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