WCE 2017: A Prospective, Multi-Institutional Assessment of 30-Day Pad-Free Continence Predicting Long-Term Continence following Robot-Assisted Radical Prostatectomy

Vancouver, Canada (UroToday.com)  Urinary incontinence post-robot assisted radical prostatectomy (RARP) greatly impacts patient quality of life and often serves as a quality-control mechanism between surgeons. However, because urinary continence recovery can take place through 1-year post-RARP, accurate data collection and high response rates complicates the issue of accurate reporting. Further, early (as opposed to long-term) follow-up is much easier to acquire.

Ms. Linda My Huynh (BS), a clinical research coordinator from the University of California – Irvine, presented a prospective, multi-institutional assessment of the use of 30-day pad-free continence status as an early metric to project one-year urinary continence rates. The group began their systematic data collection method in 2010, with pre-addressed pad-free status postcards (PFC) and daily urinary pad logs (DUPL) in assessing 30-day and 1 year pad-free status rates. 

The present study, however, is an external validation of four high-volume institutions whose patients (n=508) underwent RARP. At discharge, patients were given stamped and pre-addressed PFC and (to assess internal consistency) a DUPL with instructions to fax results every five weeks. Overall pad-free status was assessed with self-administered validated questionnaires at 6 and 12 months, with a contracted third-party calling non-responders on days 33-35. 

Overall, for the entire cohort, pad-free status at 30-days was 43% (218/508) and at 1 year, 88% (447/508). Of note, however, there were no cross-over events between 30-day and overall continence curves; this suggests that the scale is a viable and specific metric for overall continence rates at 30 days. 

Ms. Huynh does, however, mentioned that this external validation has particular limitations – more specifically, that the four institutions only included high volume surgeons whose outcomes were previously known and validated. Future direction would require that the 30-day metric should be validated in a more diverse cohort of surgeons and patients before it can be adopted on a wide-scale basis. 

Presented by: Linda My Huynh, MS

Authors: Linda Huynh, Rita Derderian, Douglas Skarecky, Thomas E. Ahlering, MD
Affiliations: University of California, Irvine

Written by: Linda Huynh (BS), assistant research specialist, University of California, Irvine, at 35th World Congress of Endourology– September 12-16, 2017, Vancouver, Canada.