Assessing the reliability and validity of a urinary incontinence scale after radical prostatectomy

Cross-cultural adaptation and validation of the Urinary Incontinence Scale After Radical Prostatectomy for the Brazilian context

OBJECTIVE

To translate, adapt, and validate the Urinary Incontinence Scale After Radical Prostatectomy for Brazil.

METHOD

Methodological study: cross-cultural adaptation (translation, synthesis, back translation, expert committee (n=25), pre-testing (n=40) and presentation to original authors) and evaluation of measurement properties (n=80). Data were collected between January 2018 and February 2019 in an oncology unit. The calculated measurement properties: structural validity, hypothesis testing, criterion validity and reliability.

RESULTS

The Brazilian version was called Escala de Incontinência Urinária Pós-Prostatectomia Radical. One item was excluded due to low factor loading (0.322). A significant correlation was identified between the total score of the scale and instruments applied (p<0.001). Incontinent men had higher scores on the total scale in relation to continents (p<0.001). Cronbach's alpha was 0.94 and composite reliability was 0.97.

CONCLUSION

The Brazilian version was considered valid and reliable for the assessment of urinary incontinence in prostatectomized patients.

Adaptação transcultural e validação da Urinary Incontinence Scale After Radical Prostatectomy para o contexto brasileiro

RESUMO Objetivo: Traduzir, adaptar e validar a Urinary Incontinence Scale After Radical Prostatectomy para o Brasil. Método: Estudo tipo metodológico: adaptação transcultural (tradução, síntese, retrotradução, comitê de especialistas (n=25), pré-teste (n=40) e apresentação para os autores originais) e avaliação das propriedades de medida (n=80). Os dados foram coletados entre janeiro de 2018 e fevereiro de 2019 em unidade oncológica. As propriedades de medida calculadas: validade estrutural, teste de hipótese, validade de critério e confiabilidade. Resultados: A versão brasileira denominou-se Escala de Incontinência Urinária Pós-Prostatectomia Radical. Um item foi excluído devido carga fatorial baixa (0,322). Identificou-se correlação significativa entre escore total da escala e instrumentos aplicados (p<0,001). Homens incontinentes apresentaram maior escore no total da escala em relação aos continentes (p<0,001). Alfa de Cronbach foi 0,94 e confiabilidade composta 0,97. Conclusão: A versão brasileira foi considerada válida e confiável para avaliação da incontinência urinária em prostatectomizados.

Improvement of Urinary Incontinence, Life Impact, and Depression and Anxiety With Modified Pelvic Floor Muscle Training After Radical Prostatectomy

Prostate cancer ranks second among male cancers in the United States in terms of death rate. Robot-assisted surgery (RAS) is now offered as the standard surgical procedure performed for radical prostatectomy. Urinary incontinence and erectile dysfunction were common complications after RAS prostatectomy. Patients felt ill-prepared after surgery, resulting in negative impacts on their quality of life. Pelvic floor muscle exercise is prioritized for patients with mild-to-moderate incontinence. The purpose of this study was to examine the effects of using resistance band pelvic floor muscle exercise for patients after RAS prostatectomy. A preexperimental single-group study was conducted for this study. A total of 43 patients completed the program. Urinary incontinence scale, Incontinence Impact Questionnaire, and Hospital Anxiety and Depression Scale were assessed at 0.5 months, 1 month, 2 months, and 3 months after urinary catheter removal. The results revealed that urinary incontinence, life impact, and depression and anxiety improved significantly as time went on. This study suggests that using simple and easy-to-learn resistance band pelvic floor muscle exercise program at home can benefit patients financially and reduce travel time.

Changes in quality of life among prostate cancer patients after surgery

BACKGROUND

Quality of life (QoL) often is impacted after radical prostatectomy (RP) procedures. Although patients' QoL scores gradually improve after RP, changes in the QoL score over time after different RP procedures must be examined.

OBJECTIVE

The aim of this study was to compare the changes in QoL over time of prostate cancer patients who were treated with open RP (ORP) or laparoscopic RP (LRP) procedures.

METHODS

A longitudinal study design was used. A convenient sample of 67 prostate cancer patients was recruited after RP (ORP = 34, LRP = 33). QoL scores were assessed at 1, 3, and 6 months after RP using the University of California, Los Angeles, Prostate Cancer Index (UCLA-PCI).

RESULTS

With respect to the PCI mean score between the ORP and LRP groups, there were significant differences in overall PCI and urinary function at time 1 (1 month after RP). However, a mixed-design analysis of covariance on the overall PCI of the 2 groups over time indicated that, after controlling for nerve sparing, there were significant differences in the main effects for group and time, but no interaction effect.

CONCLUSION

Results indicated that all patients' QoL scores improved over time. Laparoscopic RP patients' overall scores were better than ORP patients' scores, but this may be due to unmeasured preoperative differences in this nonrandom sample, and thus, these findings cannot be attributed to treatment differences alone.

IMPLICATIONS FOR PRACTICE

Patients' QoL after either RP surgery is likely to drop but is regained by 6 months. This information should be given to patients undergoing RP who are deciding between various RP procedures.