EURURO Vol. 72 No. 6

E176 1030

Letter to the Editor
Reply to Jae Heon Kim, Bora Lee, and Benjamin I.
Chung’s Letter to the Editor re: Philipp Mandel,
Felix Preisser, Markus Graefen, et al. High Chance
of Late Recovery of Urinary and Erectile Function
Beyond 12 Months After Radical Prostatectomy.
Eur Urol 2017;71:848–50
We thank Kim et al for their comments regarding our
recently published study As they noted, rates reported
for postoperative urinary incontinence (UI) and erectile
dysfunction (ED) are variable, although the cited rate of
87% for UI probably represents an outlier, while the range
of 4–31% for UI at 12 mo after radical prostatectomy (RP)
from the cited meta-analysis is conceivable .
In our study we focused on the probability of functional
recovery among patients with UI and ED at 12 mo after
radical prostatectomy. To this end, as stated in the results
part of our manuscript, we used information for incontinent
patients at 12 mo for whom further longitudinal data on
continence and erectile function were available. Patients
lost to follow-up after 12 mo were excluded from our
analyses of late functional recovery. The exact numbers of
patients with longitudinal data available were also shown
in Supplementary Table 2 of the original study. Validated
annual questionnaires were used for follow-up of patients
who underwent surgery at our center. Indeed, Kaplan-Meier
estimations could have been used for analysis of late
functional recovery. However, our aim was to report the
actual rates of late functional recovery observed instead of
calculating Kaplan-Meier estimations. We agree that the
missing information for nonresponders represents a limi-
tation of the study, as also mentioned in the manuscript.
Nevertheless, as we[1_TD$DIFF] used longitudinal data focusing on
relative changes over time, the problem of a potential
selection bias might be reduced. When comparing func-
tional outcomes at different time points for patients with
complete and only incomplete follow-up, rates of ED/UI and
patient characteristics were very similar. Moreover, when
using Kaplan-Meier estimations instead, our results remain
qualitatively the same. In agreement with our findings,
recovery rates at 36mo after RP in patients suffering fromUI
at 12 mo after RP were reported as high in previous studies
at 48% and 49%, with differing definitions of UI and different
statistical approaches Moreover, using conditional
survival analysis, as also suggested by Kim et al, Abdollah
et al observed a high chance of incontinence recovery 12 mo
after RP Further studies are warranted to confirm these
findings.
Conflicts of interest: The authors have nothing to disclose.
References
[1]
[2]
[3]
[4]
[5]
.
[6]
.
Philipp Mandela
Derya Tilkia,b, *
aMartini-Klinik Prostate Cancer Center, University Hospital Hamburg-
Eppendorf, Hamburg, Germany
bDepartment of Urology, University Hospital Hamburg-Eppendorf,
Hamburg, Germany
*Corresponding author. Martini-Klinik Prostate Cancer Center,
University Hospital Hamburg-Eppendorf, Martinistrasse 52,
20246 Hamburg, Germany.
E-mail address: (D. Tilki).
June 21, 2017
available at
journal homepage:
DOIs of original articles: .
0302-2838/# 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.