Elderly patients are not at higher risk of urinary incontinence after radical prostatectomy

N. d’Altilia 1, M. Di Nauta 1, U.G. Falagario1 1 B. Calò 1, O. Selvaggio 1, F. Sanguedolce 2, V. Mancini 1, G. Stallone 3, E. Barret 4, L. Cormio 1, G. Carrieri 1

1 Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy; 2 Department of Pathology, University Hospital of Foggia, Italy; 3 Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy; 4 Department of Urology, Institut Montsouris, Paris, France

Background and aims. The impact of age on urinary continence recovery after retropubic radical prostatectomy is debated. We tested the impact of age on urinary continence after RRP by comparing 3 age groups, namely < 60 years, 60 to 70 years, and > 70 years. 

Methods. From our prospectively-maintained database on retropubic radical prostatectomy (RRP), we identified patients aging < 60 (Group 1), 60-70 (Group 2) and > 70 years (Group 3). Postoperatively, all patients were referred to our continence nurses who assessed them by 24-h pad test and the International Consultation Incontinence Questionnaire (ICIQ-short form)at one week, then monthly for the first year, and then biannually. Patients with a 24-h pad test ≤ 20gr were considered continent.

Results. A total of 498 patients met the inclusion criteria, 108 in Group 1, 263 in Group 2 and 127 in Group 3. Continence recovery rate progressively increased over time in all groups. In spite of group 3 having a trend towards a lower continence rate, differences among groups were not statistically significant. Interestingly, multivariate analysis pointed out that, in spite of elderly patients having greater prostate volume and lower rate of nerve-sparing procedures, no factor including age significantly predicted continence recovery. 

Conclusions. Continence recovery after retropubic radical prostatectomy is a complex phenomenon. The present study pointed out that, after having taken into account potentially relevant tested variables, elderly patients were not at higher risk of urinary incontinence after this procedure.

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