Storås Anne Holck, Sanda Martin G, Garin Olatz, Chang Peter, Patil Dattatraya, Crociani Catrina, Suarez Jose Francisco, Cvancarova Milada, Loge Jon Håvard, Fosså Sophie D
Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway.
Department of Urology, Emory University Hospital, Atlanta, USA.
Asian J Urol. 2020 Apr;7(2):161-169. doi: 10.1016/j.ajur.2019.08.001. Epub 2019 Aug 19.
To compare pre- and post-radical prostatectomy (RP) responses in the urinary incontinence domain of Expanded Prostate Cancer Index Composite-26 (EPIC-26) in cohorts from the USA, Norway and Spain.
A prospective study of pre- and 1-year post-treatment responses in American (=537), Norwegian (=520) and Spanish (=111) patients, establishing the prevalence of urinary incontinence defined according to published dichotomization. Thereafter we focused on the response alternatives "occasional dribbling", pad use and problem experience. A multivariate logistic regression analysis (significance level ≤ 0.01) considered risk factors for "not retaining total control".
Compared to the European men, the American patients were younger, healthier and more presented with lower risk tumors. Before RP no inter-country differences emerged the prevalence of urinary incontinence (6%). One-year post-treatment urinary incontinence was described by 30% of the American and 41% of the European patients, occasional dribbling being the most frequent type of urinary leakage. In the multivariate analysis the risk of "not retaining total control" increased almost 3-fold in European compared to American patients, with age and co-morbidity being additional independent risk factor.
After RP patients from Spain and Norway reported more unfavorable outcomes by EPIC-26 than the American patients to most of the urinary incontinence items, the difference between the European and American patients remaining in the multivariate analysis. The most frequent post-RP response alternative "occasional dribbling" needs to be validated with pad weighing as "gold standard".
比较美国、挪威和西班牙队列中，接受根治性前列腺切除术（RP）前后在扩展前列腺癌指数综合评分-26（EPIC-26）尿失禁领域的反应。
对美国（=537例）、挪威（=520例）和西班牙（=111例）患者治疗前和治疗后1年的反应进行前瞻性研究，根据已发表的二分法确定尿失禁的患病率。此后，我们重点关注反应选项“偶尔滴沥”、使用尿垫情况和问题体验。多因素逻辑回归分析（显著性水平≤0.01）考虑了“未保持完全控制”的风险因素。
与欧洲男性相比，美国患者更年轻、更健康，且更多表现为低风险肿瘤。RP术前，各国间尿失禁患病率无差异（6%）。治疗后1年，30%的美国患者和41%的欧洲患者出现尿失禁，偶尔滴沥是最常见的尿失禁类型。在多因素分析中，与美国患者相比，欧洲患者“未保持完全控制”的风险增加近3倍，年龄和合并症是另外的独立风险因素。
RP术后，西班牙和挪威患者在EPIC-26的大多数尿失禁项目上报告的结果比美国患者更不理想，在多因素分析中欧美患者之间的差异依然存在。RP术后最常见的反应选项“偶尔滴沥”需要以尿垫称重作为“金标准”进行验证。
