OBJECTIVE: To investigate public restroom habits with secondary outcomes evaluating health-related quality of life (HRQoL) outcomes in our patients who underwent artificial urinary sphincter (AUS) implantation after prostatectomy.
Postprostatectomy incontinence is a significant burden on patients' emotional health and ability to perform activities of daily living.
METHODS: Between June 2012 and January 2014, we identified 50 men who had undergone AUS placement for postprostatectomy incontinence. All 50 men completed baseline Expanded Prostate Cancer Index Composite-Urinary Domain (EPIC-UD) and Urogenital Distress Inventory Short Form (UDI-6) questionnaires preoperatively. We evaluated patients' subjective postoperative continence status using the UDI-6 and EPIC-UD scales via a telephone-administered questionnaire.
RESULTS: Thirty-one of 50 patients (62%) were contacted and agreed to participate in the study. The pad score decreased significantly from 3 (median = 3 pads per day [ppd]; interquartile range [IQR] = 2) during minimal activity before surgery to 1 (median = 1.0 ppd; IQR = 0.5) after surgery (P < .001), and from 5 pads (median =5 ppd; IQR = 5) during strenuous activity to 1 pad (median = 1 ppd; IQR = 2; P < .001). QoL analysis pre- and post-AUS revealed a score increase of 16.5 points (P < .007) in EPIC-UD and an increase of 23.93 (P < .022) in UDI-6. Men reporting lower ppd before AUS placement were more likely to report higher public restroom urinal use (R = 0.366; P < .043) and increased public restroom comfort level (R = 0.342; P < .060) as compared with men with higher preoperative ppd usage.
CONCLUSION: EPIC-UD and UDI-6 scores improved significantly and demonstrated high levels of correlation to self-reported ppd; however, both failed to show any correlation to patients' comfort level with public restrooms. The single predictor of patients' comfort was self-reported ppd with minimal activity.
Written by:
Bukavina L, Chaparala H, Kartha G, Angermeier K, Montague D, Wood H. Are you the author?
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Urology, Cleveland Clinic, Glickman Urological Institute, Cleveland, OH; Case Western Reserve University, School of Medicine, Cleveland, OH.
Reference: Urology. 2015 Jun 2. pii: S0090-4295(15)00316-7.
doi: 10.1016/j.urology.2015.03.027
PubMed Abstract
PMID: 26048433