How do definitions affect outcomes for post-prostatectomy incontinence in a contemporary series of 1000 consecutive Robot-assisted Radical Prostatectomy?
BAUS ePoster online library. Abuelnaga M. 06/21/21; 319064; p2-6
Disclosure(s): NA
Mr. Mahmoud Abuelnaga
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Abstract
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Introduction
A significant limitation in the outcome reporting of RARP is the inconsistency in definition used for post-prostatectomy incontinence(PPI) across the literature. The variability in continence rates post RARP is enormous, ranging from 13-97.5% at 12 months post-operatively. In our study, we highlight this variability in reporting by applying six different definitions of PPI to our analysis of outcomes in our prospective series of 1000 RARPs.
Patients&Methods
A prospective database of 1000 men who underwent RARP between 2011 and 2019 was analysed. All men completed the ICIQ-UI-SF and a question on pad usage at baseline, 6 weeks, 3, 6, 12, 18 and 24 months post-RARP. Six definitions of PPI were applied (1)ICIQ score 0 (2)ICIQ score <5 (3)ICIQ score improvement or return to baseline (4)no pad use (5)0 or safety pad use and (6)0 or 1 pad use.
Results
Of the 1000 men included in the study, 76.6% reported pre-operative ICIQ-UI-SF score of 0. When continence is defined as '0 or 1 pad use', continence rate at 24 months was found to be 98%, however, when 'ICIQ-UI-SF score 0' definition was applied, it dropped to 58.6%. Continence rates varied between 11.9%-68%, 23.7-86%, 35.6%-95%, 45.8%-97%, 55%-97% and 58.6%-98% at 6 weeks, 3, 6, 12, 18 and 24 months respectively depending on whether the most strict or most inclusive definition was applied.
Conclusion
The post-prostatectomy continence definition applied creates enormous variability in the reported continence outcomes. The findings of this study highlight the importance of formulating an internationally-agreed consensus definition of PPI.
A significant limitation in the outcome reporting of RARP is the inconsistency in definition used for post-prostatectomy incontinence(PPI) across the literature. The variability in continence rates post RARP is enormous, ranging from 13-97.5% at 12 months post-operatively. In our study, we highlight this variability in reporting by applying six different definitions of PPI to our analysis of outcomes in our prospective series of 1000 RARPs.
Patients&Methods
A prospective database of 1000 men who underwent RARP between 2011 and 2019 was analysed. All men completed the ICIQ-UI-SF and a question on pad usage at baseline, 6 weeks, 3, 6, 12, 18 and 24 months post-RARP. Six definitions of PPI were applied (1)ICIQ score 0 (2)ICIQ score <5 (3)ICIQ score improvement or return to baseline (4)no pad use (5)0 or safety pad use and (6)0 or 1 pad use.
Results
Of the 1000 men included in the study, 76.6% reported pre-operative ICIQ-UI-SF score of 0. When continence is defined as '0 or 1 pad use', continence rate at 24 months was found to be 98%, however, when 'ICIQ-UI-SF score 0' definition was applied, it dropped to 58.6%. Continence rates varied between 11.9%-68%, 23.7-86%, 35.6%-95%, 45.8%-97%, 55%-97% and 58.6%-98% at 6 weeks, 3, 6, 12, 18 and 24 months respectively depending on whether the most strict or most inclusive definition was applied.
Conclusion
The post-prostatectomy continence definition applied creates enormous variability in the reported continence outcomes. The findings of this study highlight the importance of formulating an internationally-agreed consensus definition of PPI.
Introduction
A significant limitation in the outcome reporting of RARP is the inconsistency in definition used for post-prostatectomy incontinence(PPI) across the literature. The variability in continence rates post RARP is enormous, ranging from 13-97.5% at 12 months post-operatively. In our study, we highlight this variability in reporting by applying six different definitions of PPI to our analysis of outcomes in our prospective series of 1000 RARPs.
Patients&Methods
A prospective database of 1000 men who underwent RARP between 2011 and 2019 was analysed. All men completed the ICIQ-UI-SF and a question on pad usage at baseline, 6 weeks, 3, 6, 12, 18 and 24 months post-RARP. Six definitions of PPI were applied (1)ICIQ score 0 (2)ICIQ score <5 (3)ICIQ score improvement or return to baseline (4)no pad use (5)0 or safety pad use and (6)0 or 1 pad use.
Results
Of the 1000 men included in the study, 76.6% reported pre-operative ICIQ-UI-SF score of 0. When continence is defined as '0 or 1 pad use', continence rate at 24 months was found to be 98%, however, when 'ICIQ-UI-SF score 0' definition was applied, it dropped to 58.6%. Continence rates varied between 11.9%-68%, 23.7-86%, 35.6%-95%, 45.8%-97%, 55%-97% and 58.6%-98% at 6 weeks, 3, 6, 12, 18 and 24 months respectively depending on whether the most strict or most inclusive definition was applied.
Conclusion
The post-prostatectomy continence definition applied creates enormous variability in the reported continence outcomes. The findings of this study highlight the importance of formulating an internationally-agreed consensus definition of PPI.
A significant limitation in the outcome reporting of RARP is the inconsistency in definition used for post-prostatectomy incontinence(PPI) across the literature. The variability in continence rates post RARP is enormous, ranging from 13-97.5% at 12 months post-operatively. In our study, we highlight this variability in reporting by applying six different definitions of PPI to our analysis of outcomes in our prospective series of 1000 RARPs.
Patients&Methods
A prospective database of 1000 men who underwent RARP between 2011 and 2019 was analysed. All men completed the ICIQ-UI-SF and a question on pad usage at baseline, 6 weeks, 3, 6, 12, 18 and 24 months post-RARP. Six definitions of PPI were applied (1)ICIQ score 0 (2)ICIQ score <5 (3)ICIQ score improvement or return to baseline (4)no pad use (5)0 or safety pad use and (6)0 or 1 pad use.
Results
Of the 1000 men included in the study, 76.6% reported pre-operative ICIQ-UI-SF score of 0. When continence is defined as '0 or 1 pad use', continence rate at 24 months was found to be 98%, however, when 'ICIQ-UI-SF score 0' definition was applied, it dropped to 58.6%. Continence rates varied between 11.9%-68%, 23.7-86%, 35.6%-95%, 45.8%-97%, 55%-97% and 58.6%-98% at 6 weeks, 3, 6, 12, 18 and 24 months respectively depending on whether the most strict or most inclusive definition was applied.
Conclusion
The post-prostatectomy continence definition applied creates enormous variability in the reported continence outcomes. The findings of this study highlight the importance of formulating an internationally-agreed consensus definition of PPI.
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