Post-radical prostatectomy urinary incontinence: is there any discrepancy between medical reports and patients’ perceptions?
Background: Post-radical prostatectomy urinary incontinence (PPI) negatively affects the quality of life of patients. Accurate identification of the problem by physicians is essential for adequate postoperative management. In this study we sought to access whether there is, for urinary incontinence, any discrepancy between medical reports and the perception of patients. Methods: We performed a retrospective analysis of medical records of 337 patients subjected to radical retropubic prostatectomy (RRP) between 2005 and 2010. Sociodemographic variables were collected, as well as continence status over the course of treatment. Next, we contacted patients by phone to determine continence status at present and at time of their last appointment, as well as to apply ICIQ – SF questionnaire. Poisson regression model with robust variance was used to estimate the factors associated with discrepancy, using the stepwise backward strategy. Software used was Stata ® (StataCorp, LC) version 11.0. Results: There is discrepancy between medical reports and patients’ perceptions in 42.2% of cases. This discrepancy was found in 56% of elderly patients and 52% of men with low schooling, with statistical significance in these groups (p=0.069 and 0.0001, respectively), whereas in multivariate regression analysis the discrepancy rate was significantly higher in black men (discrepancy rate of 52.6%) with low schooling (p=0.004 and 0.043, respectively). Twenty-five, 25.4, 37.2 and 12.4% of incontinent patients at phone call referred usage of one security pad, one pad, 2 pads and 3 or more pads, while according to medical reports the rates were 47, 33.3, 13.6, 6.1%, respectively. Conclusion: There is discrepancy between medical reports and the perception of black men with low schooling in respect to post-radical prostatectomy urinary incontinence and a need for more thorough investigation of this condition in patients that fit this risk profile.
Urinary continence; Prostatic neoplasm; Prostatectomy; Quality-of-life; Patient-reported symptoms; Medical report
Uroneurologia / Disfunção Miccionais / Urodinâmica
Faculdade de Medicina do ABC - São Paulo - Brasil
rafael castilho borges, marcos tobias-machado, estefânia gabriotti, francisco figueiredo, carlos bezerra, sidney glina