Objective: To determine how well various definitions of continence outcome after radical retropubic prostatectomy (RP) corresponded with each other, using published health-related quality-of-life (HRQoL) questionnaires.
Patients and methods: In all, 198 patients undergoing RP alone were enrolled in a study between November 2000 and June 2003. The baseline interview was conducted before RP and 3, 6 and 12 months afterward. The disease-specific HRQoL was assessed using the University of California-Los Angeles Prostate Cancer Index; the correspondence among definitions of incontinence was investigated.
Results: The urinary function score substantially declined at 3 months, continued to recover at 6 and 12 months, but remained lower than at baseline (P < 0.001). The correspondence among definitions of continence varied widely; 97% of men who did not have urine leakage at all claimed to use no pads, but only 63% of those claiming no use of pads had no urine leakage at all. Interestingly, this concordance rate progressively changed from 46% at 3 months to 60% at 12 months, whereas it was 82% at baseline.
Conclusions: Based on self-reported questionnaire data, different definitions of continence gave different results when applied to the same patients at the same time. The correspondence among definitions may vary with time after RP. No single question adequately assesses the urinary HRQoL outcome after treatment for prostate cancer.