The Evolution of Self-Reported Urinary and Sexual Dysfunction over the Last Two Decades: Implications for Comparative Effectiveness Research

Matthew J Resnick; Daniel A Barocas; Alicia K Morgans; Sharon E Phillips; Tatsuki Koyama; Peter C Albertsen; Matthew R Cooperberg; Michael Goodman; Sheldon Greenfield; Ann S Hamilton; Karen E Hoffman; Richard M Hoffman; Sherrie H Kaplan; Dan McCollum; Lisa E Paddock; Janet L Stanford; Antoinette M Stroup; Xiao-Cheng Wu; David F Penson

doi:10.1016/j.eururo.2014.08.035

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The Evolution of Self-Reported Urinary and Sexual Dysfunction over the Last Two Decades: Implications for Comparative Effectiveness Research

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The Evolution of Self-Reported Urinary and Sexual Dysfunction over the Last Two Decades: Implications for Comparative Effectiveness Research

Matthew J Resnick, Daniel A Barocas, Alicia K Morgans, Sharon E Phillips, Tatsuki Koyama, Peter C Albertsen, Matthew R Cooperberg, Michael Goodman, Sheldon Greenfield, Ann S Hamilton, …

European urology, Vol.67(6), pp.1019-1025

06/2015

DOI: 10.1016/j.eururo.2014.08.035

PMCID: PMC4412750

PMID: 25174325

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Abstract

Despite the paramount importance of patient-reported outcomes, little is known about the evolution of patient-reported urinary and sexual function over time. To evaluate differences in pretreatment urinary and sexual function in two population-based cohorts of men with prostate cancer enrolled nearly 20 yr apart. Patients were enrolled in the Prostate Cancer Outcomes Study (PCOS) or the Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) study, two population-based cohorts that enrolled patients with incident prostate cancer from 1994 to 1995 and from 2011 to 2012, respectively. Participants completed surveys at baseline and various time points thereafter. We performed multivariable logistic and linear regression analysis to investigate differences in pretreatment function between studies. The study comprised 5469 men of whom 2334 (43%) were enrolled in PCOS and 3135 (57%) were enrolled in CEASAR. Self-reported urinary incontinence was higher in CEASAR compared with PCOS (7.7% vs 4.7%; adjusted odds ratio [OR]: 1.83; 95% confidence interval [CI], 1.39–2.43). Similarly, self-reported erectile dysfunction was more common among CEASAR participants (44.7% vs 24.0%) with an adjusted OR of 3.12 (95% CI, 2.68–3.64). Multivariable linear regression models revealed less favorable self-reported baseline function among CEASAR participants in the urinary incontinence and sexual function domains. The study is limited by its observational design and possibility of unmeasured confounding. Reporting of pretreatment urinary incontinence and erectile dysfunction has increased over the past two decades. These findings may reflect sociological changes including heightened media attention and direct-to-consumer marketing, among other potential explanations. Patient reporting of urinary and sexual function has evolved and is likely contingent on continually changing societal norms. Recognizing the evolving nature of patient reporting is essential in efforts to conduct high-quality, impactful comparative effectiveness research. Reporting of pretreatment urinary incontinence and erectile dysfunction has increased over the past two decades. These data suggest that patient reporting of urinary and sexual function is dynamic and likely is contingent on continually changing societal norms.

Urinary function

Patient-reported outcomes

Prostate cancer

Sexual function

Quality of life

Details

Title: Subtitle: The Evolution of Self-Reported Urinary and Sexual Dysfunction over the Last Two Decades: Implications for Comparative Effectiveness Research
Creators: Matthew J Resnick - Department of Urologic Surgery, Vanderbilt University, Nashville, TN, USA
Daniel A Barocas - Department of Urologic Surgery, Vanderbilt University, Nashville, TN, USA
Alicia K Morgans - Department of Medicine, Vanderbilt University, Nashville, TN, USA
Sharon E Phillips - Department of Biostatistics, Vanderbilt University, Nashville, TN, USA
Tatsuki Koyama - Department of Biostatistics, Vanderbilt University, Nashville, TN, USA
Peter C Albertsen - Division of Urology, University of Connecticut Health Center, Farmington, CT, USA
Matthew R Cooperberg - Department of Urology, University of California San Francisco, San Francisco, CA, USA
Michael Goodman - Department of Epidemiology, Emory University, Atlanta, GA, USA
Sheldon Greenfield - Department of Medicine, University of California, Irvine, Irvine, CA, USA
Ann S Hamilton - Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
Karen E Hoffman - Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Richard M Hoffman - Department of Medicine, University of New Mexico, Albuquerque, NM, USA
Sherrie H Kaplan - Department of Medicine, University of California, Irvine, Irvine, CA, USA
Dan McCollum - Eskind Biomedical Library, Vanderbilt University, Nashville, TN, USA
Lisa E Paddock - New Jersey State Cancer Registry, Trenton, NJ, USA
Janet L Stanford - Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
Antoinette M Stroup - New Jersey State Cancer Registry, Trenton, NJ, USA
Xiao-Cheng Wu - Louisiana State University Health Sciences Center, New Orleans, LA, USA
David F Penson - Department of Urologic Surgery, Vanderbilt University, Nashville, TN, USA
Resource Type: Journal article
Publication Details: European urology, Vol.67(6), pp.1019-1025
DOI: 10.1016/j.eururo.2014.08.035
PMID: 25174325
PMCID: PMC4412750
NLM abbreviation: Eur Urol
ISSN: 0302-2838
eISSN: 1873-7560
Publisher: Elsevier B.V
Language: English
Date published: 06/2015
Academic Unit: Epidemiology; General Internal Medicine; Internal Medicine
Record Identifier: 9984094308902771

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