Development of New Comorbidities in Patients Awaiting Urinary Incontinence Surgery Following Radical Prostatectomy

Urology. 2022 Jan:159:235-240. doi: 10.1016/j.urology.2021.08.048. Epub 2021 Oct 13.

Abstract

Objective: To examine the incidence and factors associated with the development of new comorbidities in men undergoing anti-incontinence surgery after prostate cancer (PCa) surgery. Post-prostatectomy incontinence (PPI) may deter men from engaging in physical activities and increase the risk of developing comorbidities after prostatectomy.

Methods: Patients undergoing surgery for PPI from 2006 to 2019 were identified. A retrospective review was performed to document patient characteristics noted at the time of PCa surgery and compare these with parameters recorded at the time of anti-incontinence surgery.

Results: A total of 229 patients were included. Mean age was 68.8 years at time of incontinence surgery. Median duration of incontinence was 3.5 ± 4.6 years. There was a significant increase in CCI comorbidities between PCa surgery and PPI surgery (2.7 ± 1.5 vs 4.1 ± 1.9, P < .0001). Almost half of patients (45.2%) developed a new comorbidity while awaiting incontinence surgery including an increase in the incidence of diabetes (21.9% vs 12.7%; p<0.0001), hypertension (56.2% vs 36.7%; P < .0001), coronary artery disease (14.6% vs 8.9%; P = .008) and arrhythmia (11.0% vs 3.8%; P = .008). On multivariable analysis, duration of incontinence was significantly associated with development of new comorbidities (O.R. 1.2, P = .01) while age (P = .20) and incontinence severity (P = 1.0) were not. There was no change in weight (P = .34), obesity (P = 1.0) or BMI (P = .18) between PCa surgery and PPI surgery.

Conclusion: Patients with PPI appear at risk of developing new comorbidities while awaiting anti-incontinence surgery. Strategies which expedite return of continence for example, early surgical intervention, may facilitate resumption of physical activity and minimize the risk of future comorbidity.

MeSH terms

  • Aged
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / surgery
  • Prostatectomy* / methods
  • Prostatic Neoplasms / surgery*
  • Retrospective Studies
  • Time-to-Treatment*
  • Urinary Incontinence / complications*
  • Urinary Incontinence / surgery