TY - JOUR
T1 - The burden of urinary incontinence and urinary bother among elderly prostate cancer survivors
AU - Kopp, Ryan P.
AU - Marshall, Lynn M.
AU - Wang, Patty Y.
AU - Bauer, Douglas C.
AU - Barrett-Connor, Elizabeth
AU - Parsons, J. Kellogg
N1 - Funding Information:
Funding/Support and role of the sponsor: The Osteoporotic Fractures in Men (MrOS) study is supported by National Institutes of Health funding. The following institutes provide support: the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institute on Aging (NIA), National Center for Research Resources (NCRR), and NIH Roadmap for Medical Research (grant numbers U01 AR45580, U01 AR45614, U01 AR45632, U01 AR45647, U01 AR45654, U01 AR45583, U01 AG18197, U01-AG027810, and UL1 RR024140). The sponsors were involved in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and approval of the manuscript.
PY - 2013/10
Y1 - 2013/10
N2 - 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.
AB - 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.
KW - Aging male
KW - Elderly
KW - Epidemiology
KW - Incontinence
KW - Lower urinary tract symptoms
KW - Prostate cancer
KW - Prostate cancer treatment
KW - Urinary bother
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U2 - 10.1016/j.eururo.2013.03.041
DO - 10.1016/j.eururo.2013.03.041
M3 - Article
C2 - 23587870
AN - SCOPUS:84883771620
SN - 0302-2838
VL - 64
SP - 672
EP - 679
JO - European Urology
JF - European Urology
IS - 4
ER -