A man's likelihood of needing a urinary incontinence procedure doubles within a 15-year period after radical prostatectomy treatment for prostate cancer, with significant risk linked to increasing patient age, radiation after treatment and low surgeon volume, report Sunnybrook researchers in the first, large, long-term study of rates of incontinence procedures among over 25,000 Canadian men, as published in the Journal of Urology.
Findings show the cumulative rate of post-prostatectomy incontinence surgery doubled from 2.8 percent at 5 years, to 4.8 percent at 15 years.
Factors predicting risk for post-prostatectomy incontinence surgery:
- patient age at the time of radical prostatectomy:
- 24 percent higher risk every decade for incontinence surgery (hazard ratio of 1.24), after age 62.2 years, the median age at time of prostate cancer surgery for the study cohort
- undergoing radiation treatment after radical prostatectomy:
- risk for incontinence surgery is 61 percent (hazard ratio of 1.61)
- increasing comorbidities (the presence of co-existing disease):
- hazard ratio per increase in aggregated disease groups sum 1.06)
- level of surgeon experience:
- greater surgeon experience (49 or more radical prostatectomies performed annually) was negatively associated or had a lower risk with a hazard ratio of 0.59