Impact of Urinary Incontinence on the Quality of Life After Open Retropubic Radical Prostatectomy

Abstract

Introduction Radical retropubic prostatectomy is one of the standard treatments for localized prostate cancer. Evaluating the severity of postoperative urinary incontinence is primordial to guiding the treatment choice, and it still lacks standardization, hence the value of assessing the quality of life. Methods We conducted a retrospective study between January 2014 and December 2018 in the Urology Department of La Rabta Hospital, involving 30 patients followed for localized prostate cancer treated with radical prostatectomy for at least one year. Our work aimed to study urinary incontinence after radical retropubic prostatectomy and to evaluate the quality of life of patients who underwent surgery for localized prostate cancer by three validated questionnaires: The International Prostate Symptom Score (IPSS), The International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) and the International Continence Society (ICS) scores. Results The preoperative IPSS score ranged from 5-22, averaging 11.13. After the surgery, it ranged between four and 23, with an average of 14.13. This increase was significant, with p = 0.001. The average preoperative ICIQ-SF score was 10.03, and the mean postoperative score was 14.23. The first question dealing with the frequency of episodes of urinary leakage has not demonstrated variation after surgery. In the second question, which deals with the amount of urine loss, we found a significant increase in this parameter with p=0.003. In the third question inherent to perceived discomfort, operated patients reported significant deterioration with p <0.001. We observed an increase in patients with urinary stress incontinence and enuresis on the ICS score after radical retropubic prostatectomy. Wearing protection or padding was required in 23.3% of patients. Conclusion IPSS, ICIQ-SF, and ICS scores are helpful to perform before and after radical retropubic prostatectomy. It helps to study urinary incontinence better, propose to each patient with postoperative complications the appropriate treatment option, and improve the quality of the urinary status.