Philipp Mandel1, Markus Graefen2, Uwe Michl2, Hartwig Huland2, Derya Tilki3. 1. Martini-Clinic Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 2. Martini-Clinic Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 3. Martini-Clinic Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany. Electronic address: d.tilki@uke.de.
Abstract
OBJECTIVES: As life expectancy increases, functional outcomes in elderly patients after radical prostatectomy (RP) become a more important factor to consider in treatment selection. The aim of this study was to determine age-dependent differences in functional outcomes after RP. PATIENTS AND METHODS: A total of 8,295 patients who underwent RP from January 2009 to July 2013 were analyzed. Univariate and multivariate logistic regressions were used to estimate the effect of age and other covariates on 3- and 12-month continence and potency rates. Continence was achieved if no more than one safety pad was used per day. Potency was defined as an international index of erectile function (IIEF)-5 score of 18 or higher. RESULTS: In the entire cohort, 12-month (3-mo) continence and potency rates were 91.0% (76.1%) and 54.6% (40.9%), respectively. The 1-year continence rates for age groups < 65, ≥ 65 and < 70, ≥ 70 and < 75, and ≥ 75 years were 93.2%, 90.8%, 86.0%, and 86.5%, respectively. The corresponding 1-year potency rates were 59.3%, 46.9%, 44.4%, and 31.3%. In both, univariate and multivariate analyses, older age had a significant negative effect on functional outcomes. Moreover, nerve sparing, pT category, and patients' body mass index were significantly associated with continence. Nerve sparing, pT category, patients' body mass index, and use of PDE5 inhibitor or intracavernous injection therapy significantly influenced potency. CONCLUSIONS: Older age has a significant adverse effect on recovery of continence and potency. Although functional outcomes in elderly patients and especially in patients aged 75 years or older are still good, they should be educated about the increased risk of incontinence and impotence after RP.
OBJECTIVES: As life expectancy increases, functional outcomes in elderly patients after radical prostatectomy (RP) become a more important factor to consider in treatment selection. The aim of this study was to determine age-dependent differences in functional outcomes after RP. PATIENTS AND METHODS: A total of 8,295 patients who underwent RP from January 2009 to July 2013 were analyzed. Univariate and multivariate logistic regressions were used to estimate the effect of age and other covariates on 3- and 12-month continence and potency rates. Continence was achieved if no more than one safety pad was used per day. Potency was defined as an international index of erectile function (IIEF)-5 score of 18 or higher. RESULTS: In the entire cohort, 12-month (3-mo) continence and potency rates were 91.0% (76.1%) and 54.6% (40.9%), respectively. The 1-year continence rates for age groups < 65, ≥ 65 and < 70, ≥ 70 and < 75, and ≥ 75 years were 93.2%, 90.8%, 86.0%, and 86.5%, respectively. The corresponding 1-year potency rates were 59.3%, 46.9%, 44.4%, and 31.3%. In both, univariate and multivariate analyses, older age had a significant negative effect on functional outcomes. Moreover, nerve sparing, pT category, and patients' body mass index were significantly associated with continence. Nerve sparing, pT category, patients' body mass index, and use of PDE5 inhibitor or intracavernous injection therapy significantly influenced potency. CONCLUSIONS: Older age has a significant adverse effect on recovery of continence and potency. Although functional outcomes in elderly patients and especially in patients aged 75 years or older are still good, they should be educated about the increased risk of incontinence and impotence after RP.
Authors: Derya Tilki; Valentin Maurer; Raisa S Pompe; Felix K Chun; Felix Preisser; Alexander Haese; Markus Graefen; Hartwig Huland; Philipp Mandel Journal: World J Urol Date: 2019-04-02 Impact factor: 4.226
Authors: Annika Herlemann; Alexander Buchner; Alexander Kretschmer; Maria Apfelbeck; Christian G Stief; Christian Gratzke; Stefan Tritschler Journal: World J Urol Date: 2017-05-10 Impact factor: 4.226
Authors: Vincent Beck; Boris Schlenker; Annika Herlemann; Maria Apfelbeck; Alexander Buchner; Christian Gratzke; Christian G Stief; Stefan Tritschler Journal: World J Urol Date: 2018-09-17 Impact factor: 4.226