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. 2021 Aug;40(6):1550-1558.
doi: 10.1002/nau.24703. Epub 2021 May 18.

Individual risk prediction of urinary incontinence after prostatectomy and impact on treatment choice in patients with localized prostate cancer

Corinne N Tillier  1 , Ruben D Vromans  2   3 , Annelies H Boekhout  3 , Hans Veerman  1   4 , Barbara M Wollersheim  3 , Henricus A M van Muilekom  1 , Thierry N Boellaard  5 , Pim J van Leeuwen  6 , Lonneke V van de Poll-Franse  3   7   8 , Henk G van der Poel  1
Affiliations

Individual risk prediction of urinary incontinence after prostatectomy and impact on treatment choice in patients with localized prostate cancer

Corinne N Tillier et al. Neurourol Urodyn. 2021 Aug.

Abstract

Aims: Individualized information about the risk of incontinence after prostatectomy could help patients in shared decision-making.

Methods: We compared a historical control cohort (n = 254; between June 2016 and 2017) that received standardized information about the risk of incontinence after robot-assisted radical prostatectomy (RARP) with a prospective patient cohort (n = 254; between June 2017 and May 2018) that received individualized information of the chance of recovery of incontinence within 6 months postoperatively based on the continence prediction tool (CPRED). We measured switch in treatment choice, health-related quality of life (QoL) in both cohorts and the accuracy of the CPRED tool.

Results: Patients in the individualized information group with RARP as initial preference switched more often to another treatment than patients who received standardized information (16% vs. 5%; p = 0.001). Patients in the individualized information group with a high risk of incontinence and with RARP as initial preference switched more often to other treatments than patients in intermediate/low risk of incontinence (35% vs. 9.8%; p = 0.001). Patients with a low risk of incontinence choosing RARP after individualized information were less likely to use more than one diaper a day at any time postoperative (p = 0.001) compared to men with an intermediate/high incontinence risk. Overall QoL was worse in patients with incontinence than patients with continence 6 and 12 months after RARP (respectively; p < 0.0001 and p = 0.007).

Conclusion: Personalized information about the risk of incontinence after RARP makes more patients reconsidering their initial treatment preference. The CPRED correlated strongly with continence outcome after RARP and is a useful tool for shared decision-making.

Keywords: CPRED; RARP; individual predictor continence; quality of life; shared-decision making.

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References

REFERENCES

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