Questionnaire-based outcomes of urinary incontinence and satisfaction rates after radical prostatectomy in a national study population

Objectives. To assess the incidence of incontinence and the associated quality of life in men younger than 65 years of age after radical prostatectomy. Methods. The TRICARE/CHAMPUS database was searched to identify 1000 patients who underwent radical prostatectomy within 2 years before study initiation. All patients were younger than 65 years of age at the time of surgery and had at least 18 months of postoperative follow-up. An eight-part questionnaire focusing on continence after surgery was mailed to the study population. Respondents reported on voiding dysfunction, degree of incontinence, satisfaction with continence, and lifestyle impact of incontinence. Results. A total of 674 eligible patients (78%) completed the survey. Any amount of pad use or changing of underwear to keep dry was reported by 31.7%, leakage once per day occurred in 16.8%, and leakage more than once per day in 9.2%. Severe urgency or urge incontinence occurred in 17.4% and was the primary cause of incontinence in one third of patients with incontinence. Only 8.9% of patients used two or more pads per day, and severe incontinence (more than four pads per day) occurred in 2.7%. Incontinence-corrective surgery was used by 4.9% of patients. Overall, 83.3% of patients reported satisfaction with their continence after surgery, and 12% considered postoperative incontinence to be a problem. Conclusions. The results of this questionnaire-based outcomes evaluation of a large national sample of prostatectomy patients younger than 65 years of age demonstrate that incontinence rates in this younger population are similar to those in the Medicare population and may be more representative of the national experience than single-center reports.