Evidence map›Paper›PMID 38152486›Full record

ArticleEuropean urology open science2023

Does Centralization of Radical Prostatectomy Reduce the Incidence of Postoperative Urinary Incontinence?

Maike H J Schepens, Miranda L van Hooff, Onno van der Galiën, Cathelijne M P Ziedses des Plantes, Diederik M Somford, Pim J van Leeuwen, Martijn B Busstra, Sjoerd Repping, Michel W J M Wouters, Jacques van Limbeek

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In one paragraph

Article in European urology open science, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.8field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 1 country.

Maike H J SchepensDepartment of Biomedical Data Sciences, Leiden UMC, Leiden, The Netherlands.
Miranda L van HooffDepartment of Orthopedic Surgery, Radboud UMC, Nijmegen, The Netherlands.
Onno van der GaliënDepartment of Strategy and Innovation, Zilveren Kruis Health Insurance, Zeist, The Netherlands.
Cathelijne M P Ziedses des PlantesDepartment of External Affairs, Janssen-Cilag BV, Breda, The Netherlands.
Diederik M SomfordDepartment of Urology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
Pim J van LeeuwenDepartment of Urology, Netherlands Cancer Institute, Netherlands Prostate Cancer Network, Amsterdam, The Netherlands.
Martijn B BusstraDepartment of Urology, Erasmus Medical Center, Rotterdam, The Netherlands.
Sjoerd ReppingAmsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Michel W J M WoutersDepartment of Biomedical Data Sciences, Leiden UMC, Leiden, The Netherlands.
Jacques van LimbeekDepartment of Medical Advice, Zilveren Kruis Health Insurance, Zeist, The Netherlands.
The Netherlands Cancer Institute · NLAmsterdam University Medical Centers · NLCanisius-Wilhelmina Ziekenhuis · NLErasmus MC · NLJanssen (Netherlands) · NLRadboud University Nijmegen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: On the basis of previous analyses of the incidence of urinary incontinence (UI) after radical prostatectomy (RP), the hospital RP volume threshold in the Netherlands was gradually increased from 20 per year in 2017, to 50 in 2018 and 100 from 2019 onwards. Objective: To evaluate the impact of hospital RP volumes on the incidence and risk of UI after RP (RP-UI). Design setting and participants: Patients who underwent RP during 2016-2020 were identified in the claims database of the largest health insurance company in the Netherlands. Incontinence was defined as an insurance claim for ≥1 pads/d. Outcome measurements and statistical analysis: The relationship between hospital RP volume (HV) and RP-UI was assessed via multivariable analysis adjusted for age, comorbidity, postoperative radiotherapy, and lymph node dissection. Results and limitations: RP-UI incidence nationwide and by RP volume category did not decrease significantly during the study period, and 5-yr RP-UI rates varied greatly among hospitals (19-85%). However, low-volume hospitals (≤120 RPs/yr) had a higher percentage of patients with RP-UI and higher variation in comparison to high-volume hospitals (>120 RPs/yr). In comparison to hospitals with low RP volumes throughout the study period, the risk of RP-UI was 29% lower in hospitals shifting from the low-volume to the high-volume category (>120 RPs/yr) and 52% lower in hospitals with a high RP volume throughout the study period (>120 RPs/yr for 5 yr). Conclusions: A focus on increasing hospital RP volumes alone does not seem to be sufficient to reduce the incidence of RP-UI, at least in the short term. Measurement of outcomes, preferably per surgeon, and the introduction of quality assurance programs are recommended. Patient summary: In the Netherlands, centralization of surgery to remove the prostate (RP) because of cancer has not yet improved the occurrence of urinary incontinence (UI) after surgery. Hospitals performing more than 120 RP operations per year had better UI outcomes. However, there was a big difference in UI outcomes between hospitals.

Indexed as

OutcomesProstate cancerRadical prostatectomyUrinary incontinenceVolume-outcome relationship

Identifiers

PMID38152486
PMCPMC10751543
OpenAlexW4388478920

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.