METHODS: We performed a retrospective analysis of medical records of 337 patients subjected to radical retropubic prostatectomy (RRP) between 2005 and 2010. Sociodemographic variables were collected, as well as continence status over the course of treatment. Next, we contacted patients by phone to determine continence status at present and at time of their last appointment, as well as to apply ICIQ - SF questionnaire. Poisson regression model with robust variance was used to estimate the factors associated with discrepancy, using the stepwise backward strategy. Software used was Stata® (StataCorp, LC) version 11.0.
RESULTS: There is discrepancy between medical reports and patients\' perceptions in 42.2% of cases. This discrepancy was found in 56% of elderly patients and 52% of men with low schooling, with statistical significance in these groups (p = 0.069 and 0.0001, respectively), whereas in multivariate regression analysis the discrepancy rate was significantly higher in black men (discrepancy rate of 52.6%) with low schooling (p = 0.004 and 0.043, respectively).
CONCLUSIONS: There is discrepancy between medical reports and the perception of black men with low schooling in respect to post-radical prostatectomy urinary incontinence and a need for more thorough investigation of this condition in patients that fit this risk profile.
方法:我们对2005年至2010年间接受耻骨后前列腺癌根治术(RRP)的337例患者的病历进行了回顾性分析。收集了社会人口统计学变量,以及治疗过程中的尿失禁状况。接下来,我们通过电话联系患者,以确定目前和上次预约时的失禁状况,以及应用ICIQ-SF问卷。使用具有稳健方差的泊松回归模型来估计与差异相关的因素,使用逐步向后战略。使用的软件是Stata®(StataCorp,LC)版本11.0。
结果:在42.2%的病例中,医学报告与患者的感知之间存在差异。在56%的老年患者和52%的受教育程度低的男性中发现了这种差异,在这些组中具有统计学意义(分别为p=0.069和0.0001),而在多元回归分析中,受教育程度低的黑人男性(差异率为52.6%)的差异率明显更高(分别为p=0.004和0.043).
结论:医学报告与受教育程度较低的黑人男性在前列腺癌根治术后尿失禁方面的看法存在差异,并且需要对符合该风险特征的患者进行更彻底的调查。