Risk factors to predict incontinence for prostate cancer patients

Published 07 March 2017

Researchers have identified risk factors for prostate cancer patients undergoing surgery that may help determine how quickly they regain continence, according to ground-breaking research by a team including the University of New England.

Professor Neil Smart from the School of Science and Technology says they have found various preoperative risk factors that can affect continence recovery.

Neil Smart

“The preoperative length of the membranous urethra is one anatomical factor that has been reported to affect the recovery of continence following prostate surgery. So the value for clinicians is the counselling they can give to patients prior to surgery about the delay in continence recovery.”

In the majority of patients, urinary incontinence is often a side effect of the main type of surgery used to treat prostate cancer called Radical Prostatectomy (RP).

“The key findings suggest that a greater preoperative MUL has a significant positive effect on overall time of continence recovery. An extra centimetre of MUL means the odds of returning to continence is more than 200% more likely than for a man with a shorter MUL.”

This is the first systematic review that has investigated preoperative membranous urethra length (MUL) as a prognostic risk factor for continence recovery.

“Despite improvements in surgical techniques the incidence of urinary incontinence remains high and whether they gain continence varies. Typically urinary incontinence resolves gradually with time, with reports of significant improvement happening up to two years following surgery,” said Prof Smart.

He says this is one of the main factors that impacts on the quality of life for prostate cancer patients.

This study is important when counselling patients prior to and following surgery, in particular when setting expectations and the likely time line for the recovery of continence.

“There is also an economic burden of post urinary incontinence including the cost of lost work productivity.”

The paper Preoperative Membranous Urethral Length Measurement and Continence Recovery Following Radical Prostatectomy: A Systematic Review and Meta-analysis has been published in the European Urology 71(3) March 2017, pages 368-378.