Are we giving prostate cancer patients the right continence information?

29 April 2019, Tim Burton - 

Incontinence is a common and significant side effect of prostate cancer treatment. Whilst most patients’ initial primary treatment concern may be getting the cancer out of their bodies, it is important to ensure that men are being given all the information they need regarding side effects that affect quality of life after surgery.

TUF researchers, Dr Alison Bray and Consultant Urological Surgeon Mr Jon Aning, are looking at how we can give prostate cancer patients more relevant and better information about what their treatment could mean for their urinary function.

We aren’t giving patients the full picture

It is well known that incontinence is a common side effect of radical prostatectomy, and there is no doubt all prostate cancer patients are counselled about this, but currently we are lacking a full picture of exactly how exactly urinary function will change following surgery. There isn’t the data available to provide us with a full picture.

Dr Alison Bray is hoping to add the missing pieces of the puzzle. Her research is looking to get a more detailed understanding of what robotic radical prostatectomy will mean for flow rates, voided volumes, and frequency of trips to the toilet, both at night and during the day.

Quantifying urinary function before and after surgery

flowtakerParticipants in Alison’s study will be provided with a Flowtaker device (pictured). The device is a single-patient-use, portable, electronic home flowmeter and voiding diary.

For patients this will mean using the device each time they go to the toilet for up to two weeks before and twelve months after the operation. The device will measure flow rate and voided volume and will feed this information back with the time and date.

By collating the data provided by the Flowtaker devices from 30 patients and correlating this with urinary quality of life questionnaires, Alison and her team will be able to draw up a detailed picture of what post-operative urinary function will be like for patients.

As Alison told us, “Our patients have expressed that they are very keen for objective information about the likelihood of lower urinary tract dysfunction after surgery, in addition to indicators of their progress thereafter. They feel that this is currently an omission that affects their mental health and quality of life.

“We plan to formally document and evaluate these issues during the study by generating qualitative data that looks at what patients were told about urinary function following treatment and what their experience ended up being.”

This information could change treatment decisions

Alison and her team are looking to continue this research by seeing how urinary function might be impacted by other treatments, such as radiotherapy, as well as prostatectomy.

“If the data provide us with a clear picture of how different treatments affect urinary function, this could feed into the treatment decision-making process. For example, if radiotherapy is shown to lead to poorer flow, and prostatectomy to urinary frequency, then this additional information will allow clinicians to guide patients to the decisions that are best for them.

“We also hope to find out whether urinary function before treatment can help predict urinary side effects afterwards. If so, we could provide Flowtaker devices to clinicians so that a patient’s urinary patterns can be observed beforehand. If the patient has a problem with flow already, then this might suggest that the problem could be aggravated by radiotherapy.”

You can help us to fund more life-changing research like Alison’s by donating today.


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