Treatment of post-prostatectomy urinary incontinence (UI) and erectile dysfunction (ED) increases quality of life (QoL). Aim of our study was to evaluate the utilisation of care among patients with post-prostatectomy UI and ED in Germany.
The HAROW study documented treatment of patients with localised prostate cancer (≤ T2c) in Germany. 1260 patients underwent radical prostatectomy (RP). Patients answered validated questionnaires after a median follow-up of 6.3 years. Response rate was 76.8%.
Median age at RP was 65 (IQR 60-69) years. 14% (134/936) used more than one pad per day for UI. 25% (26/104, 30 missing) of UI patients underwent surgery to improve continence. Of patients without surgery, 41% (31/75) reported a moderate-to-severe issue concerning their incontinence with worse mental health and QoL. 81% (755/936) patients were unable to have an erection firm enough for sexual intercourse. Of all ED patients, 40% (319/793) used ED treatment regularly or tried it at least once. 49% (243/499) of patients with interest in sex never tried ED treatment. In multivariate analysis, patients not using ED treatments were older (≥ 70 years OR 4.1), and more often had preoperative ED (OR 2.3) and less interest in sex (OR 2.2). Nevertheless, 30% (73/240) of these patients had moderate-to-severe issues with their ED reporting worse mental health and QoL.
Almost half of the patients without post-prostatectomy UI and ED treatment reported moderate-to-severe issues with a significant decrease in QoL. This indicates an insufficient utilisation of care in Germany.
World journal of urology. 2020 Dec 01 [Epub ahead of print]
Martin Baunacke, Maria-Luisa Schmidt, Christer Groeben, Angelika Borkowetz, Christian Thomas, Rainer Koch, Falk Hoffmann, Felix K H Chun, Lothar Weissbach, Johannes Huber
Department of Urology, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany., Department of Health Services Research, Carl Von Ossietzky University, Ammerlaender Heerstrasse 140, 26111, Oldenburg, Germany., Department of Urology, Goethe-University Hospital, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany., Health Research for Men gGmbH, Gfm, Claire-Waldoff-Strasse 3, 10117, Berlin, Germany., Department of Urology, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany. .