UroToday - The Effect of Comorbidities and Socioeconomic Status on Sexual and Urinary Function in Men Undergoing Prostate Cancer Screening - Abstract

February 23, 2008

Friday, 22 February 2008

Cancer Prognostics and Health Outcomes Unit, University of Montreal,

Montreal, Quebec, Canada.

Comorbidities and socioeconomic status (SES) represent known confounders of

baseline health-related quality of life.

Aim: To assess the effect of comorbidities and of SES variables on urinary

function (UF) and sexual function (SF) and on associated bother items.

A cohort of 1,162 men without an established diagnosis of prostate cancer

(PCa) completed questionnaires addressing SES characteristics, the lifetime

prevalence of 12 comorbid conditions, SF and UF as well as their associated

bother.

Crude and adjusted logistic regression models tested the association between

the predictors, SES and comorbidity, and four separate outcomes, namely SF

and UF and their associated bother. Results. Of all men, aged 40-79 years,

172 (14.8%) reported poor or very poor ability to have an erection, and for

165 (14.2%), erectile function (EF) was a big or moderate problem. Daily or

weekly urinary incontinence was reported by 98 (8.4%) men, and for 94 (8.1%)

men, UF was a big or moderate problem. One or more comorbidities were

present in 437 (37.6%) men. In age- and SES-adjusted analyses, major

depression and diabetes had the most detrimental effect on EF (5.8 [P <

0.001] and 4.8 [P < 0.001], respectively) and on sexual bother (4.3 [P <

0.001] and 7.2 [P < 0.001], respectively). Stroke (4.7 [P = 0.004]) and drug

problems (4.8 [P = 0.002]) had the most detrimental effect on urinary

incontinence. Alcoholism and alcohol-related problems (3.1 [P = 0.004]) had

the most detrimental effect on the urinary bother scale. Finally, SES only

affected urinary incontinence, which was poorer in men who lived with a

spouse or partner (2.1 [P = 0.03]).

Select comorbidities have very strong effects on UF and EF. Conversely, for

most SES variables, the effect was weak and insignificant. In consequence,

when patients are assessed for definitive PCa therapy, comorbidities require

an adjustment, whereas SES assessment may potentially be omitted, especially

if questionnaire brevity is a consideration.

Written by

Bhojani N, Perrotte P, Jeldres C, Suardi N, Hutterer G, Shariat SF,

Karakiewicz PI.

Reference

J Sex Med. 2008 Jan 21. Epub ahead of print.

PubMed Abstract

PMID:18221289

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