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Nationwide, population‐based study of post radical prostatectomy urinary incontinence correction surgery
Author(s) -
Ventimiglia Eugenio,
Folkvaljon Yasin,
Carlsson Stefan,
Bratt Ola,
Montorsi Francesco,
Volz Daniela,
Akre Olof,
Johansson Eva,
Stattin Pär
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24816
Subject(s) - medicine , prostatectomy , hazard ratio , confidence interval , urinary incontinence , prostate cancer , cohort , surgery , cohort study , prom , urology , cancer , obstetrics
Objectives To assess the use of post radical prostatectomy (RP) urinary incontinence (PPI) surgery and to investigate factors related to its use. Methods Cohort study in Prostate Cancer database Sweden (PCBaSe) of men who underwent primary RP between 1998 and 2012. PPI correction procedures were identified in the Patient Registry. Hazard ratios (HR) and 95% confidence intervals (CIs) of PPI surgeries were estimated. Results Seven hundred eighty‐two out of 26 280 (3%) men underwent PPI surgery at a median time of 3 years after RP. There was an eightfold increase in the absolute number of PPI surgeries during 2000‐2014 and a threefold increase in the number per 1000 RPs performed. Factors associated with high use PPI surgery were age >70, HR 1.96 (1.54‐2.50), and high hospital RP volume (>100 RPs/year), HR 0.81 (0.66‐0.99). There was a 10‐fold difference in use of PPI surgery per 1000 RPs between the county with the highest versus lowest use. In a subgroup of men with Patient‐Reported Outcome Measures (PROM); severe PPI was reported by 7% of men and 24% of them underwent PPI surgery. Conclusions Three percent of all men received PPI surgery, with a 10‐fold variation among health care providers. Only a quarter of men with severe PPI underwent PPI surgery, suggesting that PPI surgery remains underutilized.