Quality of life in post-radical retropubic prostatectomy (RRP) patients : clinical relevance of urinary incontinence and efficacy of conservative management in response to the need of urinary elimination

Introduction. Urinary incontinence is difficult to tolerate after RRP; conservative management can be performed by nurses, but its efficacy is not clear. Aim of the study. Evaluating the effect of pelvic floor exercises, managed by nurses, on post-RRP urinary incontinence and quality of life. Methods. Our descriptive study is in progress in a major hospital. Estimated final sample size of 250 patients (2003 - june 2010) stratified by risk factors for incontinence. Data collection through clinical records and interviews is in progress to define prevalence ( end: august 2009). Inclusion criteria: prostate-limited cancer, in-dwelling catheter for max. 8 days, regular flow exam after removal. Before the treatment, a nurse assesses incontinence (PC test, 24-h pad-tests). Patients are then taught pelvic floor exercises; the same evaluation is repeated weekly. A validated questionnaire (EORTC PR-25) investigates their quality of life, before and after the treatment, which ends when patients show losses <10 grams/day during effort. Data will be analyzed through Principal Component Analysis and t-test/ANOVA. Results. Preliminary results: reduction of daily losses in every patient. Preliminary, informal interviews based upon the PR-25 questionnaire show improved quality of life scores for all of them. Conclusion / discussion Nurses have a role in the conservative management of incontinence, although its efficiency and cost-effectiveness are still under investigation. Practical relevance. Incontinence seems a common problem, with deep effects on QOL; nurses can help in this field. Research implications. We will give a contribution in defining the prevalence of incontinence, which in literature seems unclear.