BACKGROUND: Data describing urinary health in elderly, community-dwelling prostate cancer (PCa) survivors are limited. OBJECTIVE: To elucidate the prevalence of lower urinary tract symptoms, urinary bother, and incontinence in elderly PCa survivors compared with peers without PCa. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional analysis of 5990 participants in the Osteoporotic Fractures in Men Research Group, a cohort study of community-dwelling men ≥ 65 yr. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We characterized urinary health using self-reported urinary incontinence and the American Urological Association Symptom Index (AUA-SI). We compared urinary health measures according to type of PCa treatment in men with PCa and men without PCa using multivariate log-binomial regression to generate prevalence ratios (PRs). RESULTS AND LIMITATIONS: At baseline, 706 men (12%) reported a history of PCa, with a mean time since diagnosis of 6.3 yr. Of these men, 426 (60%) reported urinary incontinence. In adjusted analyses, observation (PR: 2.11; 95% confidence interval [CI], 1.22-3.65; p=0.007), surgery (PR: 4.41; 95% CI, 3.79-5.13; p<0.0001), radiation therapy (PR: 1.49; 95% CI, 1.06-2.08; p=0.02), and androgen-deprivation therapy (ADT) (PR: 2.02; 95% CI, 1.31-3.13; p=0.002) were each associated with daily incontinence. Daily incontinence risk increased with time since diagnosis independently of age. Observation (PR: 1.33; 95% CI, 1.00-1.78; p=0.05), surgery (PR: 1.25; 95% CI, 1.10-1.42; p=0.0008), and ADT (PR: 1.50; 95% CI, 1.26-1.79; p<0.0001) were associated with increased AUA-SI bother scores. Cancer stage and use of adjuvant or salvage therapies were not available for analysis. CONCLUSIONS: Compared with their peers without PCa, elderly PCa survivors had a two-fold to five-fold greater prevalence of urinary incontinence, which rose with increasing survivorship duration. Observation, surgery, and ADT were each associated with increased urinary bother. These data suggest a substantially greater burden of urinary health problems among elderly PCa survivors than previously recognized.
BACKGROUND: Data describing urinary health in elderly, community-dwelling prostate cancer (PCa) survivors are limited. OBJECTIVE: To elucidate the prevalence of lower urinary tract symptoms, urinary bother, and incontinence in elderly PCa survivors compared with peers without PCa. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional analysis of 5990 participants in the Osteoporotic Fractures in Men Research Group, a cohort study of community-dwelling men ≥ 65 yr. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We characterized urinary health using self-reported urinary incontinence and the American Urological Association Symptom Index (AUA-SI). We compared urinary health measures according to type of PCa treatment in men with PCa and men without PCa using multivariate log-binomial regression to generate prevalence ratios (PRs). RESULTS AND LIMITATIONS: At baseline, 706 men (12%) reported a history of PCa, with a mean time since diagnosis of 6.3 yr. Of these men, 426 (60%) reported urinary incontinence. In adjusted analyses, observation (PR: 2.11; 95% confidence interval [CI], 1.22-3.65; p=0.007), surgery (PR: 4.41; 95% CI, 3.79-5.13; p<0.0001), radiation therapy (PR: 1.49; 95% CI, 1.06-2.08; p=0.02), and androgen-deprivation therapy (ADT) (PR: 2.02; 95% CI, 1.31-3.13; p=0.002) were each associated with daily incontinence. Daily incontinence risk increased with time since diagnosis independently of age. Observation (PR: 1.33; 95% CI, 1.00-1.78; p=0.05), surgery (PR: 1.25; 95% CI, 1.10-1.42; p=0.0008), and ADT (PR: 1.50; 95% CI, 1.26-1.79; p<0.0001) were associated with increased AUA-SI bother scores. Cancer stage and use of adjuvant or salvage therapies were not available for analysis. CONCLUSIONS: Compared with their peers without PCa, elderly PCa survivors had a two-fold to five-fold greater prevalence of urinary incontinence, which rose with increasing survivorship duration. Observation, surgery, and ADT were each associated with increased urinary bother. These data suggest a substantially greater burden of urinary health problems among elderly PCa survivors than previously recognized.
Authors: Kathryn L Taylor; George Luta; Anthony B Miller; Timothy R Church; Scott P Kelly; Larry R Muenz; Kimberly M Davis; David L Dawson; Sara Edmond; Douglas Reding; Jerome E Mabie; Thomas L Riley Journal: J Clin Oncol Date: 2012-06-25 Impact factor: 44.544
Authors: Martin G Sanda; Rodney L Dunn; Jeff Michalski; Howard M Sandler; Laurel Northouse; Larry Hembroff; Xihong Lin; Thomas K Greenfield; Mark S Litwin; Christopher S Saigal; Arul Mahadevan; Eric Klein; Adam Kibel; Louis L Pisters; Deborah Kuban; Irving Kaplan; David Wood; Jay Ciezki; Nikhil Shah; John T Wei Journal: N Engl J Med Date: 2008-03-20 Impact factor: 91.245
Authors: Richard M Hoffman; Frank D Gilliland; David F Penson; S Noell Stone; William C Hunt; Arnold L Potosky Journal: Cancer Date: 2004-11-01 Impact factor: 6.860
Authors: Matthew J Resnick; Tatsuki Koyama; Kang-Hsien Fan; Peter C Albertsen; Michael Goodman; Ann S Hamilton; Richard M Hoffman; Arnold L Potosky; Janet L Stanford; Antoinette M Stroup; R Lawrence Van Horn; David F Penson Journal: N Engl J Med Date: 2013-01-31 Impact factor: 91.245
Authors: Valentin H Meissner; Kathleen Herkommer; Birgitt Marten-Mittag; Jürgen E Gschwend; Andreas Dinkel Journal: J Cancer Surviv Date: 2017-05-21 Impact factor: 4.442
Authors: Sarathi Kalra; Spyridon Basourakos; Angela Abouassi; Mary Achim; Robert J Volk; Karen E Hoffman; John W Davis; Jeri Kim Journal: Nat Rev Urol Date: 2016-03-22 Impact factor: 14.432
Authors: J Kellogg Parsons; John P Pierce; James Mohler; Electra Paskett; Sin-Ho Jung; Peter Humphrey; John R Taylor; Vicky A Newman; Leslie Barbier; Cheryl L Rock; James Marshall Journal: Contemp Clin Trials Date: 2014-05-13 Impact factor: 2.226
Authors: Leonard N Chen; Simeng Suy; Hongkun Wang; Aditi Bhagat; Jennifer A Woo; Rudy A Moures; Joy S Kim; Thomas M Yung; Siyuan Lei; Brian T Collins; Keith Kowalczyk; Anatoly Dritschilo; John H Lynch; Sean P Collins Journal: Radiat Oncol Date: 2014-06-26 Impact factor: 3.481