Surgeon volume and patient-reported urinary incontinence after radical prostatectomy. Population-based register study in Sweden

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Godtman, Rebecka Arnsrud,1981Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology,Univ Göteborg, Sahlgrenska Univ Hosp, Inst Clin Sci, Dept Urol,Sahlgrenska Acad, Gothenburg, Sweden. (author)

Surgeon volume and patient-reported urinary incontinence after radical prostatectomy. Population-based register study in Sweden

Article/chapterEnglish2022

Publisher, publication year, extent ...

2022-09-06
Medical Journals Sweden AB,2022

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LIBRIS-ID:oai:gup.ub.gu.se/322102
https://gup.ub.gu.se/publication/322102URI
https://doi.org/10.1080/21681805.2022.2119270DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-497002URI
http://kipublications.ki.se/Default.aspx?queryparsed=id:150626521URI

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Language:English

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Subject category:art swepub-publicationtype

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Objective: To investigate the association between surgeon volume and urinary incontinence after radical prostatectomy. Methods: A total of 8326 men in The National Prostate Cancer Register of Sweden (NPCR) underwent robot-assisted radical prostatectomy (RARP) between 2017 and 2019 of whom 56% (4668/8 326) had responded to a questionnaire one year after RARP. The questionnaire included the question: ‘How much urine leakage do you experience?’ with the response alternatives ‘Not at all’, ‘A little’, defined as continence and ‘Moderately’, ‘Much/Very much’ as incontinence. Association between incontinence and mean number of RARPs/year/surgeon was analysed with multivariable logistic regression including age, Charlson Comorbidity Index (CCI), PSA, prostate volume, number of biopsy cores with cancer, cT stage, Gleason score, lymph node dissection, nerve sparing intent and response rate to the questionnaire. Results: 14% (659/4 668) of the men were incontinent one year after RARP. There was no statistically significant association between surgeon volume and incontinence. Older age (>75 years vs. < 65 years, OR 2.29 [95% CI 1.48–3.53]), higher CCI (CCI 2+ vs. CCI 0, OR 1.37 [95% CI 1.04–1.80]) and no nerve sparing intent (no vs. yes OR 1.53 [95% CI 1.26–1.85]) increased risk of incontinence. There were large differences in the proportion of incontinent men between surgeons with similar annual volumes, which remained after adjustment. Conclusions: The lack of association between surgeon volume and incontinence and the wide range in outcome between surgeons with similar volumes underline the importance of individual feedback to surgeons on functional results. © 2022 The Author(s). Published by Informa UK Limited trading as Taylor & Francis Group.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Urologi och njurmedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Urology and Nephrology hsv//eng
Electronic PROM
incontinence
patient-reported outcome measures
prostate cancer
radical prostatectomy
robotic-assisted radical prostatectomy
volume
Electronic PROM

Added entries (persons, corporate bodies, meetings, titles ...)

Persson, E.Reg Canc Ctr Mid Sweden, Uppsala, Sweden. (author)
Bergengren, OskarUppsala universitet,Urologkirurgi(Swepub:uu)oskka588 (author)
Carlsson, S.Karolinska Institutet (author)
Johansson, EvaUppsala universitet,Urologkirurgi(Swepub:uu)evajo131 (author)
Robinsson, D.Hogland Hosp, Dept Urol, Eksjo, Sweden. (author)
Hugosson, Jonas,1955Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology,Univ Göteborg, Sahlgrenska Univ Hosp, Inst Clin Sci, Dept Urol,Sahlgrenska Acad, Gothenburg, Sweden.(Swepub:gu)xhugjo (author)
Stattin, PärUppsala universitet,Urologkirurgi(Swepub:uu)parst892 (author)
Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för urologi (creator_code:org_t)

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In:Scandinavian Journal of Urology: Medical Journals Sweden AB2168-18052168-1813

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