Background/significance:

For localised PCa the benefit from surgical intervention is usually seen only beyond 10 years and thus the risk of dying is weighed against the potential for adverse outcomes.   The perceived greater risk of complications in men over 70, in particular urinary incontinence, is often cited as a reason to deny these men curative surgical treatment, even when an aggressive tumour is present that appears likely to progress within their lifetime.

Objectives:

The aim of this study is to compare the recovery of urinary continence (UC) after robotic assisted radical prostatectomy (RARP) in men greater and less than 70 years of age. 

Methods:

262 patients having undergone RARP by two surgeons were identified through their prospectively collected public and private databases between 3 May 2008 and 14^th September 2012 after exclusions. 

Detailed demographic, staging, peri-operative and continence data was collected; the primary outcome measure was pads/day. Simple frequencies were the primary statistical method employed. 

Results:

10.1% of the cohort were >70 yo.  In men greater than and less than 70yo the mean age was 59.7 and 71.1 respectively. There were a greater number of D’Amico intermediate and high-risk patients in the >70yo cohort.

At 4-6 weeks, Men > 70yo required on average 2 pads/day (13.3% fully continent) compared to men <70yo requiring 1 pad/day (38.4% fully continent). By 3 months and all time points thereafter, the mean pads/day and % patients fully continent showed little difference between groups.

Conclusion:

At 4-6 weeks recovery of UC was worse for men >70yo however equalised in comparison to their younger counterparts thereafter.  Our experience suggests that preclusion of older, healthy, high-risk men on the grounds of poorer continence recovery may need to be revisited.