Difference in Incontinence Pad Use between Patients after Radical Prostatectomy and Cancer-Free Population with Subgroup Analysis for Open vs. Minimally Invasive Radical Prostatectomy: A Descriptive Analysis of Insurance Claims-Based Data

Dong-Ho Mun, Lin Yang, Shahrokh F. Shariat, Sylvia Reitter-Pfoertner, Gerald Gredinger and Thomas Waldhoer
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Dong-Ho Mun: Department of Urology, Medical University of Vienna, 1090 Vienna, Austria
Lin Yang: Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB T2S 3C3, Canada
Shahrokh F. Shariat: Department of Urology, Medical University of Vienna, 1090 Vienna, Austria
Sylvia Reitter-Pfoertner: Competence Center Integrated Care, c/o Austrian Health Insurance Fund, 1100 Vienna, Austria
Gerald Gredinger: Competence Center Integrated Care, c/o Austrian Health Insurance Fund, 1100 Vienna, Austria
Thomas Waldhoer: Center for Public Health, Department of Epidemiology, Medical University of Vienna, 1090 Vienna, Austria

IJERPH, 2021, vol. 18, issue 13, 1-9

Abstract: Purpose: to quantify and compare pre- and post-surgical incontinence pad use between men treated with radical prostatectomy (RP) for prostate cancer (PCa) and cancer-free controls, using population-based Austrian insurance claims data. Methods: Men who underwent RP for treating PCa between 2013–2015 were identified. Cancer-free men ?45 years with and without benign prostate hyperplasia (BPH) were used as controls. Longitudinal data on ICD-diagnoses, type of surgery, prescribed incontinence pads, and hospitals’ surgery volumes were aggregated between 2011–2018 to capture pre- and up to three years post-RP follow-up. Monthly rates of pad use were calculated and compared between RP types and cancer-free controls. Results: A total of 6248 RP patients, 7158 cancer-free men with BPH, and 50,257 cancer-free men without BPH were analyzed. Comparing to pre-RP (0.03, 95%CI: 0.02–0.05), RP resulted in significantly higher rates of prescribed pads (at 3 months: 12.61, 95%CI: 11.59–13.65; 12 months: 6.71, 95%CI: 6.10–7.34; 36 months: 4.91, 95%CI: 3.76–4.62). These rates were also higher than those for cancer free controls (with BPH:0.06, 95%CI: 0.04–0.09; without BPH:0.12, 95%CI: 0.10–0.14). The rate of prescribed pads after surgery continued to decline over time and remained higher among men who underwent minimally invasive RP compared to those who underwent an open procedure. Conclusion: Despite progress in surgical techniques, post-RP incontinence remains a prevalent adverse event. The rate of pad usage steadily improved over the first three years post RP. The rate of patients with incontinence needing pads was higher among those who were treated minimally invasive compared to open approach.

Keywords: insurance data; laparoscopic radical prostatectomy; open radical prostatectomy; robotic radical prostatectomy; urinary incontinence (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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