Detailed characterisation of severe incontinence after robotic-assisted radical prostatectomy using urodynamics and patient reported outcome measures
BAUS ePoster online library. MacKenzie K. Jun 26, 2018; 211326; P5-9
Mr. Kenneth MacKenzie
Mr. Kenneth MacKenzie
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Abstract
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Introduction: Urinary incontinence after robotic-assisted radical prostatectomy (RARP) can ruin mens quality of life. Few studies have performed detailed analysis of post-RARP incontinence in men considering having surgery to improve their leakage. This study investigated the urodynamic and patient-reported outcome measure (PROM) data of men considering surgery for post-RARP incontinence in a single UK centre performing RARP and incontinence surgery.

Methods: All men referred with post-RARP incontinence to a specialist clinic between December 2012 and October 2017 were evaluated. In our institution men were routinely invited to complete the International Consultation on Incontinence Questionnaire on Male Lower Urinary Tract Symptoms Long Form (ICIQ-MLUTS) pre-RARP and at 6,12 and 18 months post-RARP. All men underwent urodynamics. Data were analysed by paired t-test.

Results: In total 64/795(8%) men post-RARP were referred to the specialist clinic, of these 16/64(25%) had had salvage radiation. Median age, BMI and prostate size were: 66 years(R 52-74), 28(R 19-35) and 45 grams(R 15-165). Urodynamics identified 41/64(64%) had stress incontinence, 2/64(3%) detrusor overactivity, 11/64(17%) mixed symptoms and 10/64(16%) no urodynamic evidence of incontinence. After evaluation 26/64(41%) men proceeded to undergo incontinence surgery. Table 1 illustrates the patient-reported ICIQ-MLUTS LF data pre- and post surgery by urodynamic categories.

Conclusions: A significant proportion of men considering surgery for post-RARP incontinence had no urodynamic incontinence or mixed symptoms. The ICIQ-MLUTS LF was able to identify significant changes from baseline in men concerned about their post-RARP urinary symptoms. This study demonstrates the utilty of routine collection of PROMs for counselling men post-RARP.
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