# The Impact of Early Postoperative Urinary Incontinence on Presenteeism After Robot‐Assisted Radical Prostatectomy for Prostate Cancer: A Prospective Cohort Study

## TL;DR

This study finds that urinary incontinence after prostate cancer surgery significantly reduces work productivity in the first three months, with the biggest impact in the first month.

## Contribution

The study quantifies the impact of early postoperative urinary incontinence on presenteeism after robot-assisted radical prostatectomy.

## Key findings

- Median ICIQ-SF scores increased significantly post-surgery, indicating higher incontinence severity.
- Presenteeism dropped to 64.9% at one month post-surgery and partially recovered to 75.3% at three months.
- UI severity and impact on daily life were moderately correlated with lower presenteeism scores.

## Abstract

Urinary incontinence (UI) in the first 3 months after robot‐assisted radical prostatectomy (RARP) frequently impairs work performance, yet its quantitative impact on presenteeism remains unclear. This prospective cohort study longitudinally evaluated how early postoperative UI influences presenteeism among employed Japanese men undergoing RARP.

We consecutively enrolled 92 employed male patients scheduled for RARP and assessed them preoperatively, at discharge, and at 1‐ (PS‐1) and 3‐month (PS‐3) post‐surgery. Outcomes were the International Consultation on Incontinence Questionnaire‐Short Form (ICIQ‐SF), WHO Health and Work Performance Questionnaire (HPQ)‐Presenteeism Scale, King's Health Questionnaire (KHQ), and Kessler Psychological Distress Scale (K6).

Of the 92 eligible participants, 85 (92.4%) completed the PS‐1 and 80 (87.0%) completed the PS‐3 assessment. Median ICIQ‐SF total scores increased from 0 (IQR 0–2) preoperatively to 9 (6–12) at PS‐1, remaining elevated at 7 (4–10) at PS‐3 (p < 0.001). Mean HPQ‐presenteeism declined from 81.4% ± 13.9% preoperatively to 64.9% ± 18.8% at PS‐1, partially recovering to 75.3% ± 16.1% at PS‐3 (p < 0.001). At PS‐1, UI impact on daily life (ρ = −0.45) and ICIQ‐SF total (ρ = −0.43) were moderately associated with lower presenteeism; at PS‐3, correlations persisted and extended to multiple KHQ subscales (ρ = −0.41 to −0.53).

Early postoperative UI after RARP produces a clinically meaningful reduction in work productivity, greatest at PS‐1 and still evident at PS‐3. Targeted continence care and occupational support during this window may mitigate productivity loss and facilitate sustainable return to work.