Yonsei Med J.  2010 Nov;51(6):883-887. 10.3349/ymj.2010.51.6.883.

Discrepancies in Perception of Urinary Incontinence between Patient and Physician after Robotic Radical Prostatectomy

• Lee SR
• Kim HW
• Lee JW
• Jeong WJ
• Rha KH
• Kim JH

• KMID: 1779635
• DOI: http://doi.org/10.3349/ymj.2010.51.6.883

Abstract

PURPOSE
Reported incidence of urinary incontinence after a radical prostatectomy (RP) varies between studies. This may be due not only to the definition of incontinence applied, but also how the information is acquired. We investigated the differences in perception of post robot-assisted laparoscopic RP (RALP) urinary incontinence acquired through doctor interviews and patient-reported questionnaires.
MATERIALS AND METHODS
Of 238 consecutive men who underwent RALP by a single surgeon between July 2005 and February 2008, we evaluated 66 men using the International Consultation on Incontinence Questionnaire (ICIQ) at various time points after surgery. Each patient's ICIQ results were considered to be the patient's perceptions of urinary incontinence. The physician at the same time directly interviewed the patients about the number of pads used and considered complete continence to be equivalent to the use of no pads or safety liners.
RESULTS
Of the 66 patients, the physician reported that 34 (51.5%) had obtained complete continence. However, analysis of the questionnaires of these 34 patients revealed that only 5 (14.7%) patients reported that they never leaked during the past 4 weeks. Most patients (11 patients, 32.4%) who did not use any pad did in fact reported leakage of a small or moderate amount of urine about once a day.
CONCLUSION
Our results indicate that there are discrepancies in the perception of urinary incontinence between doctor and patient after RALP. Non-use of pads is not equivalent to obtaining complete urinary continence. Therefore, the number of pads used is not a good measure to determine the status of complete urinary continence.

Keyword

Radical prostatectomy; urinary incontinence; questionnaire

MeSH Terms

Aged
Aged, 80 and over
Biopsy
Humans
Laparoscopy/methods
Male
Middle Aged
Perception
Physician-Patient Relations
Prostatectomy/*adverse effects/methods
Questionnaires
Robotics
Treatment Outcome
Urinary Incontinence/*etiology

Figure

• 

  Fig. 1 (A) Correlation between the scores for questions 1 and 2 of the ICIQ (r = 0.636, p = 0.001). (B) Correlation between scores for question 3 and the sum of questions 1 and 2 of the ICIQ (r = 0.704, p = 0.001). ICIQ, International Consultation on Incontinence Questionnaire.

• 

  Fig. 2 (A) Correlation between the number of pads used per day and the sum of scores for questions 1 and 2 of the ICIQ (r = 0.427, p = 0.001). (B) Distribution of the number of patients according to the sum of scores for questions 1 and 2 of the ICIQ. ICIQ, International Consultation on Incontinence Questionnaire.

• 

  Fig. 3 (A) Distribution of the number of patients according to pad use and question 1 of the ICIQ. (B) Distribution of the number of patients according to pad use and question 2 of the ICIQ. (C) Distribution of the number of patients according to pad use and question 3 of the ICIQ. (D) Distribution of the number of patients according to pad use and the sum of scores for questions 1 and 2 of the ICIQ. ICIQ, International Consultation on Incontinence Questionnaire.

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