Standing cough test for evaluation of post-prostatectomy incontinence: a pilot study.
Can J Urol
; 24(1): 8664-8669, 2017 Feb.
Article
en En
| MEDLINE
| ID: mdl-28263134
ABSTRACT
INTRODUCTION:
We implemented a standardized Standing Cough Test (SCT) for assessment of men with post-prostatectomy incontinence (PPI) and stratified results according to an objective clinical grading scale in an attempt to facilitate male anti-incontinence surgical procedure selection. MATERIALS ANDMETHODS:
SCT was routinely performed during the initial outpatient consultation for PPI. Incontinence severity was recorded based on a novel Male Stress Incontinence Grading Scale (MSIGS) to stratify PPI. Each patient was assigned an incontinence grade score of 0 through 4 during the SCT. Men with mild stress urinary incontinence (SUI) (grades 0-2) were offered sling surgery while those with heavier SUI (grades 3-4) were offered artificial urinary sphincter (AUS). MSIGS grade was correlated to preoperative patient-reported pads per day (PPD), and patient-reported outcomes of anti-incontinence surgery were assessed.RESULTS:
Among 62 consecutive PPI patients, 20 (32%) were graded as mild based on SCT, while the majority (42/62, 68%) were graded as moderate-severe. Average time from prostatectomy to treatment was 6 years. MSIGS grade demonstrated a strong correlation with preoperative PPD (r = 0.74). Among the 53 patients who underwent surgery for PPI, 14 with mild SUI received a sling, while 39 (74%) more severe cases received an AUS. Patient-reported improvement was high overall in both groups (median 95%).CONCLUSION:
Most men with chronic PPI present for definitive treatment in a delayed manner after prostatectomy despite having severe incontinence. The SCT provides immediate, objective information about the severity of PPI which strongly correlates with patient-reported pads-per-day and may expedite anti-incontinence surgical procedure selection.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Prostatectomía
/
Incontinencia Urinaria de Esfuerzo
/
Índice de Severidad de la Enfermedad
/
Tos
Tipo de estudio:
Etiology_studies
Aspecto:
Patient_preference
Límite:
Aged
/
Aged80
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Can J Urol
Asunto de la revista:
UROLOGIA
Año:
2017
Tipo del documento:
Article
País de afiliación:
Estados Unidos