To elucidate the prevalence of lower urinary tract symptoms, urinary bother, and incontinence in elderly PCa survivors compared with peers without PCa.
A cross-sectional analysis of 5990 participants in the Osteoporotic Fractures in Men Research Group, a cohort study of community-dwelling men ¡Ý65 yr.
We characterized urinary health using self-reported urinary incontinence and the American Urological Association Symptom Index (AUA-SI). We compared urinary health measures according to type of PCa treatment in men with PCa and men without PCa using multivariate log-binomial regression to generate prevalence ratios (PRs).
At baseline, 706 men (12 % ) reported a history of PCa, with a mean time since diagnosis of 6.3 yr. Of these men, 426 (60 % ) reported urinary incontinence. In adjusted analyses, observation (PR: 2.11; 95 % confidence interval [CI], 1.22-3.65; p = 0.007), surgery (PR: 4.41; 95 % CI, 3.79-5.13; p < 0.0001), radiation therapy (PR: 1.49; 95 % CI, 1.06-2.08; p = 0.02), and androgen-deprivation therapy (ADT) (PR: 2.02; 95 % CI, 1.31-3.13; p = 0.002) were each associated with daily incontinence. Daily incontinence risk increased with time since diagnosis independently of age. Observation (PR: 1.33; 95 % CI, 1.00-1.78; p = 0.05), surgery (PR: 1.25; 95 % CI, 1.10-1.42; p = 0.0008), and ADT (PR: 1.50; 95 % CI, 1.26-1.79; p < 0.0001) were associated with increased AUA-SI bother scores. Cancer stage and use of adjuvant or salvage therapies were not available for analysis.
Compared with their peers without PCa, elderly PCa survivors had a two-fold to five-fold greater prevalence of urinary incontinence, which rose with increasing survivorship duration. Observation, surgery, and ADT were each associated with increased urinary bother. These data suggest a substantially greater burden of urinary health problems among elderly PCa survivors than previously recognized.