PD37-02 OBESITY, WEIGHT GAIN AND NEW COMORBIDITIES IN PATIENTS WITH URINARY INCONTINENCE FOLLOWING PROSTATE CANCER SURGERY

INTRODUCTION AND OBJECTIVE: Approximately 3-5% of patients develop urinary incontinence following prostate cancer surgery. Post-prostatectomy incontinence (PPI) can have debilitating social consequences which may deter the patient from engaging in physical activity and increase the risk of developing comorbidities. The aim of this study was to examine the effect of PPI on the development of weight gain and new comorbidities in patients with PPI undergoing anti-incontinence surgery. METHODS: Patients who underwent surgery for PPI at a single center from 2004-2018 were identified. A retrospective review was performed to document patient characteristics as noted at the time of prostate cancer treatment and compare these with parameters recorded at the time of anti-incontinence surgery. Demographics included weight, body mass index (BMI), individual medical comorbidities and Charlson Comorbidity Index (CCI). Multivariate regression analysis was performed to identify factors which might influence differences in health outcomes following prostatectomy. RESULTS: A total of 229 patients were included in the study with a mean age of 68.8 years at the time of incontinence surgery. Median duration of incontinence was 3.5±4.6 years. There was no change in weight (91.1 vs. 91.8 kg; p=0.34), obesity (43.6% vs. 41.8%; p=1.0) or BMI (29.6 vs. 30.0; p=0.18) between prostate cancer surgery and PPI surgery. There was a significant increase in CCI between prostate cancer surgery and PPI surgery (2.7±1.5 vs 4.1±1.9, p<0.0001). Almost half of patients (45.2%) developed a new comorbidity while awaiting incontinence surgery including an increase in the incidence of diabetes (21.9% vs. 12.7%; p<0.0001), hypertension (56.2% vs. 36.7%; p<0.0001), coronary artery disease (14.6% vs. 8.9%; p=0.008) and arrhythmia (11.0% vs. 3.8%); p=0.008). On multivariate analysis, the duration of incontinence (years) significantly predicted the likelihood of developing a new comorbidity (O.R. 1.2; 95%CI 1.1-1.4; p<0.01) while age (p=0.20) and severity of incontinence (p=1.0) did not. CONCLUSIONS: Patients with PPI may be at higher risk of developing new comorbidities while awaiting anti-incontinence surgery which may be related to the duration of incontinence. Strategies which expedite return of continence such as early surgical intervention, may facilitate the resumption of physical activity and minimise the risk of future comorbidity. Source of Funding: none