Urinary incontinence and erectile dysfunction in patients with localized or locally advanced prostate cancer: A nationwide observational study.

Autor: Vernooij RWM; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands., Cremers RGHM; Department of Urology, Deventer Hospital, Deventer, the Netherlands., Jansen H; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands., Somford DM; Department of Urology, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands., Kiemeney LA; Radboud Institute for Health Sciences, Department of Urology, Radboud university medical center, Nijmegen, the Netherlands; Radboud Institute for Health Sciences, Department for Health Evidence, Radboud university medical center, Nijmegen, the Netherlands., van Andel G; Department of Urology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands., Wijsman BP; Department of Urology, Elisabeth-TweeSteden hospital, Tilburg, the Netherlands., Busstra MB; Department of Urology, Erasmus University Medical Center, Rotterdam, the Netherlands., van Moorselaar RJA; Department of Urology, Amsterdam University Medical Center, Amsterdam, the Netherlands., Wijnen EM; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands., Pos FJ; Department of Radiotherapy, Antoni van Leeuwenhoek - Netherlands Cancer Institute, Amsterdam, the Netherlands., Hulshof MCCM; Department of Radiotherapy, Amsterdam University Medical Center, Amsterdam, the Netherlands., Hamberg P; Department of Oncology, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands., van den Berkmortel F; Department of Oncology, Zuyderland Medical Center, Sittard-Geleen, the Netherlands., Hulsbergen-van de Kaa CA; Department of Pathology, Laboratory for Pathology East Netherlands, Hengelo, the Netherlands., van Leenders GJLH; Department of Pathology, Erasmus University Medical Center, Rotterdam, the Netherlands., Fütterer JJ; Department of Radiology, Radboud University Medical Center, Nijmegen, the Netherlands., van Oort IM; Radboud Institute for Health Sciences, Department of Urology, Radboud university medical center, Nijmegen, the Netherlands., Aben KKH; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands; Radboud Institute for Health Sciences, Department for Health Evidence, Radboud university medical center, Nijmegen, the Netherlands. Electronic address: k.aben@iknl.nl.
Jazyk: angličtina
Zdroj: Urologic oncology [Urol Oncol] 2020 Sep; Vol. 38 (9), pp. 735.e17-735.e25. Date of Electronic Publication: 2020 Jul 15.
DOI: 10.1016/j.urolonc.2020.05.022
Abstrakt: Background: Although urinary adverse events after treatment of prostate cancer (CaP) are common, population-based studies on functional outcomes are scarce. The aim of this study is to evaluate the occurrence of urinary incontinence (UI) and erectile dysfunction (ED) in daily clinical practice using a nationwide Dutch cohort of patients with localized or locally advanced CaP.
Basic Procedures: Patients were invited to complete the EPIC-26 questionnaire before treatment (baseline) and at 12 and 24 months after diagnosis. We calculated the mean EPIC-26 domain scores, stratified by treatment modality (i.e., radical prostatectomy, external radiotherapy, and no active treatment), and the proportions of patients with UI (defined as ≥ 2 pads per day) and ED (defined as erections not firm enough for sexual intercourse). Logistic regression modeling was used to explore the factors related to UI and ED after surgery.
Main Findings: In total 1,759 patients participated in this study. Patients undergoing radical prostatectomy experienced clinically relevant worsening in the urinary incontinence domain. After excluding patients who reported UI at baseline, 15% of patients with prostatectomy reported UI 24 months after diagnosis. Only comorbidity was associated with UI in surgically treated patients. Regardless of treatment, patients reported a clinically significant reduced sexual functioning over time. Before treatment, 54% of patients reported ED. Among the 46% remaining patients, 87% of patients treated with radical prostatectomy reported ED 24 months after diagnosis, 41% after radiotherapy, and 46% in patients without active treatment. Bilateral nerve-sparing surgery was the only factor associated with ED after 24 months.
Principal Conclusions: UI and ED frequently occur in patients with localized and locally advanced CaP, in particular after radical prostatectomy. The higher occurrence rate of UI and ED, compared with clinical trial participants, supports the importance of real-world data, which can be used for local treatment recommendations and patient information, but also to evaluate effects of future initiatives, such as treatment centralization and research aimed at improving functional outcomes.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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