Korean J Adult Nurs.  2019 Jun;31(3):293-302. 10.7475/kjan.2019.31.3.293.

The Effect of Post-prostatectomy Urinary Incontinence on Health-related Quality of Life in Patients with Prostate Cancer

• Kim JH
• Jang YS
• Choi YD
• Oh EG

• KMID: 2450093
• DOI: http://doi.org/10.7475/kjan.2019.31.3.293

Abstract

PURPOSE
The purpose of this study was to examine the degree of Health-Related Quality of Life (HRQoL), and determine the effect of Urinary Incontinence (UI) on HRQoL in patients after prostatectomy.
METHODS
The participants were 110 adults who had undergone radical prostatectomies at Severance Hospital in Seoul, Korea. The data of this cross-sectional study were collected between April 10, 2015, and June 12, 2015. The questionnaire included demographic and disease-related characteristics, the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), and the King's Health Questionnaire (KHQ). Descriptive statistics and multiple linear regression were used.
RESULTS
The mean age was 66.27±7.24 years. The mean score of HRQoL was 47.37 (range 0~100). The lowest-ranked domains were "physical limitations" (M=51.21) and "role limitations" (M=49.85). The HRQoL was significantly different according to the number of post-operative day. HRQoL was significantly correlated with UI, and was affected by UI. The regression model of this study accounted for 70% of the HRQoL.
CONCLUSION
UI might influence HRQoL in patients after prostatectomy. Nursing interventions with special consideration of UI are needed to improve their HRQoL.

MeSH Terms

Adult
Cross-Sectional Studies
Humans
Korea
Linear Models
Nursing
Prostate*
Prostatectomy
Prostatic Neoplasms*
Quality of Life*
Seoul
Urinary Incontinence*

Reference

1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2018; 68(6):394–424. DOI: 10.3322/caac.21492.

2. Ministry of Health and Welfare. Cancer registration statistics [Internet]. Seoul: Ministry of Health and Welfare;2017. cited 2018 December 31. Available from: http://kosis.kr/statisticsList/statisticsListIndex.do?menuId=M_01_01&vwcd=MT_ZTITLE&parmTabId=M_01_01#SelectStatsBoxDiv.

3. Stanford JL, Feng Z, Hamilton AS, Gilliland FD, Stephenson RA, Eley JW, et al. Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: the prostate cancer outcomes study. JAMA. 2000; 283(3):354–360. DOI: 10.1001/jama.283.3.354.

4. Ko WJ, Han HH, Kim KH, Han JH, Kim DW, Ko EY. Current status of urologic robotic surgery in Korea [Internet]. Goyang: National Health Insurance Service Ilsan Hospital;2014. cited 2018 December 30. Available from: https://www.nhimc.or.kr/cntFileDownLoad.do?DownLoadDir=/down_data/audit/&FileName=audit05_etc14.pdf.

5. Chang JI, Lam V, Patel MI. Preoperative pelvic floor muscle exercise and postprostatectomy incontinence: a systematic review and meta-analysis. European Urology. 2016; 69(3):460–467. DOI: 10.1016/j.eururo.2015.11.004.

6. Wallerstedt A, Nyberg T, Carlsson S, Thorsteinsdottir T, Stranne J, Tyritzis SI, et al. Quality of life after open radical prostatectomy compared with robot-assisted radical prostatectomy. European Urology Focus. 2018; Forthcoming. DOI: 10.1016/j.euf.2017.12.010.

7. Brown ML, Lipscomb J, Snyder C. The burden of illness of cancer: economic cost and quality of life. Annual Review of Public Health. 2001; 22:91–113. DOI: 10.1146/annurev.publhealth.22.1.91.

8. Yamabe K, Liebert R, Flores N, Pashos C. Health-related quality-of-life, work productivity, and economic burden among patients with Parkinson's disease in Japan. Journal of Medical Economics. 2018; 21(12):1206–1212. DOI: 10.1080/13696998.2018.1522638.

9. Waller J, Pattison N. Men's experiences of regaining urinary continence following robotic-assisted laparoscopic prostatectomy (RALP) for localised prostate cancer: a qualitative phenomenological study. Journal of Clinical Nursing. 2013; 22(3-4):368–378. DOI: 10.1111/jocn.12082.

10. Kim YS, Han JS. Lived experience of elders with prostate cancer. Journal of Korean Gerontological Nursing. 2012; 14(3):182–190.

11. Dijkstra-Eshuis J, Van den, Splinter R, Bever RFM, Zonnerveld WCG, Putter H, et al. Effect of preoperative pelvic floor muscle therapy with biofeedback versus standard care on stress urinary incontinence and quality of life in men undergoing laparoscopic radical prostatectomy: a randomised control trial. Neurourology and Urodynamics. 2015; 34(2):144–150. DOI: 10.1002/nau.22523.

12. Haglind E, Carlsson S, Stranne J, Wallerstedt A, Wilderäng U, Thorsteinsdottir T, et al. Urinary incontinence and erectile dysfunction after robotic versus Open radical prostatectomy: a prospective, controlled, nonrandomised trial. European Urology. 2015; 68(2):216–225. DOI: 10.1016/j.eururo.2015.02.029.

13. Cho OH, Yoo YS, Cha KS, Kim MW. Lower urinary tract symptoms of elderly prostate cancer patients. Journal of Korean Academic Society of Home Care Nursing. 2011; 18(2):126–132.

14. Chae J, Kim Y. Factors influencing the quality of life of prostate cancer patients. Asian Oncology Nursing. 2017; 17(4):237–245. DOI: 10.5388/aon.2017.17.4.237.

15. Yang GJ, Kang JH, Suh IS, Kim HY. Health-related quality of life and depression after radical prostatectomy or hormonal therapy. Asian Oncology Nursing. 2013; 13(4):248–255. DOI: 10.5388/aon.2013.13.4.248.

16. Namiki S, Ishidoya S, Kawamura S, Tochigi T, Arai Y. Quality of life among elderly men treated for prostate cancer with either radical prostatectomy or external beam radiation therapy. Journal of Cancer Research and Clinical Oncology. 2010; 136(3):379–386. DOI: 10.1007/s00432-009-0665-6.

17. Shin DW, Lee SH, Kim TH, Yun SJ, Nam JK, Jeon SH, et al. Health-Related Quality of Life changes in prostate cancer patients after radical prostatectomy: a longitudinal cohort study. Cancer Research and Treatment. 2019; 51(2):556–567. DOI: 10.4143/crt.2018.221.

18. Koike H, Kohjimoto Y, Iba A, Kikkawa K, Yamashita S, Iguchi T, et al. Health-related quality of life after robot-assisted radical prostatectomy compared with laparoscopic radical prostatectomy. Journal of Robotic Surgery. 2017; 11(3):325–331. DOI: 10.1007/s11701-016-0659-8.

19. Geraerts I, Van Poppel H, Devoogdt N, Laenen A, De Groef A, Van Kampen M. Progression and predictors of physical activity levels after radical prostatectomy. BJU International. 2014; 114(2):185–192. DOI: 10.1111/bju.12465.

20. Shao IH, Chang YH, Hou CM, Lin ZF, Wu CT. Predictors of short-term and long-term incontinence after robot-assisted radical prostatectomy. Journal of International Medical Research. 2018; 46(1):421–429. DOI: 10.1177/0300060517715396.

21. Sandhu JS, Eastham JA. Factors predicting early return of continence after radical prostatectomy. Current Urology Reports. 2010; 11(3):191–197. DOI: 10.1007/s11934-010-0108-6.

22. Wei Y, Wu YP, Lin MY, Chen SH, Lin YZ, Li XD, et al. Impact of obesity on long-term urinary incontinence after radical prostatectomy: a meta-analysis. BioMed Research International. 2018; 2018:8279523. DOI: 10.1155/2018/8279523.

23. Karakiewicz PI, Bhojani N, Neugut A, Shariat SF, Jeldres C, Graefen M, et al. The effect of comorbidity and socioeconomic status on sexual and urinary function and on general healthrelated quality of life in men treated with radical prostatecto my for localized prostate cancer. The Journal of Sexual Medicine. 2008; 5(4):919–927. DOI: 10.1111/j.1743-6109.2007.00741.x.

24. Teber D, Sofikerim M, Ates M, Gözen AS, Güzen O, Sanli Ö, et al. Is type 2 diabetes mellitus a predictive factor for incontinence after laparoscopic radical prostatectomy? A matched pair and multivariate analysis. Journal of Urology. 2010; 183(3):1087–1091. DOI: 10.1016/j.juro.2009.11.033.

25. Cohen Jacob. Statistical power analysis for the behavioral sciences. 2nd ed. New Jersey: Lawrence Erlbaum Associates;1988.

26. Avery K, Donovan J, Peters TJ, Shaw C, Gotoh M, Abrams P. ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourology and Urodynamics. 2004; 23(4):322–330. DOI: 10.1002/nau.20041.

27. Kelleher CJ, Cardozo LD, Khullar V, Salvatore S. A new questionnaire to assess the quality of life of urinary incontinent women. British Journal of Obstetrics and Gynaecology. 1997; 104(12):1374–1379. DOI: 10.1111/j.1471-0528.1997.tb11006.x.

28. Oh SJ, Choo MS, Kim HS, Kim JC, Lee JG, Yun JM, et al. Psychometric properties of the Korean version of the King's Health Questionnaire in women with stress urinary incontinence. Journal of the Korean Continence Society. 2005; 9(2):115–123. DOI: 10.5213/jkcs.2005.9.2.115.

29. Okamura K, Nojiri Y, Osuga Y. Reliability and validity of the King's Health Questionnaire for lower urinary tract symptoms in both genders. BJU International. 2009; 103(12):1673–1678. DOI: 10.1111/j.1464-410X.2008.08335.x.

30. Korea Society for the Study of Obesity. 2018 Clinical practice guidelines for overweight and obesity in Korea. Seoul: Korea Society for The Study of Obesity;2018.

31. Perez FSB, Rosa NC, da Rocha AF, Peixoto LRT, Miosso CJ. Effects of biofeedback in preventing urinary incontinence and erectile dysfunction after radical prostatectomy. Frontiers in Oncology. 2018; 8:20. DOI: 10.3389/fonc.2018.00020.

32. Jung SM. Prostate cancer patient's experiences with da Vinci robot surgery [master's thesis]. Seoul: Chung-Ang University;2015.

33. Park J, Lee H. The effect of telephone-enforced pelvic floor muscle exercise on incontinence, urinary function related satisfaction, depression, and quality of life for prostate cancer patients. korean Journal of Adult Nursing. 2015; 27(4):406–417. DOI: 10.7475/kjan.2015.27.4.406.

34. Franco AVM, Lee F, Fynes MM. Is there an alternative to pad tests? Correlation of subjective variables of severity of urinary loss to the 1-h pad test in women with stress urinary incontinence. BJU International. 2008; 102(5):586–590. DOI: 10.1111/j.1464-410X.2008.07612.x.