Katarina Koss Modig: Incontinence after prostate cancer surgery
Urinary incontinence is one of the most common complications following prostate cancer surgery. Katarina Koss Modig’s doctoral thesis identifies risk factors for this complication. She suggests discussing these risk factors with patients when choosing prostate cancer treatments.
KATARINA KOSS MODIG
Dissertation defense: 11 June 2024 (click for details)
Doctoral thesis: Complications and side effects of Robot Assisted Radical Prostatectomy with focus on anastomotic stenosis and urinary incontinence
Research area: Urology
Sahlgrenska Academy, The Institute of Clinical Sciences
Prostate cancer is the most common cancer among men in Sweden. Surgery is one of the curative treatments, involving the removal of the entire prostate. This procedure carries the risk of side effects or complications.
“Urinary incontinence is one of the most common complications after prostate cancer surgery. It negatively affects patients’ quality of life. A less common complication is stricture at the site where the bladder is sutured to the urethral stump,” says Katarina Koss Modig, a urologist at Sahlgrenska University Hospital who is now pursuing a doctorate at the Institute of Clinical Sciences.
Urinary incontinence and stricture
What is the focus of your research?
“All curative treatments for prostate cancer carry the risk of side effects or complications. My thesis investigates some of these, focusing mainly on urinary incontinence and stricture after surgery,” says Katarina Koss Modig, adding:
“We still do not know why some patients experience incontinence while others do not. At the urology department at Sahlgrenska, we have been conducting the IPA study for some years. Using MRI, ultrasound, and urodynamic tests before and three months after surgery, we hope to identify factors behind urinary incontinence in patients who have undergone prostate cancer surgery.”
Analysis of 4,000 patients
What are the key findings of your thesis?
“Using data from a large Swedish study, we analyzed 4,000 patients and found that the incidence of stricture at the site where the bladder is sutured to the urethral stump is influenced by the surgical method, whether open or robot-assisted laparoscopic surgery. Such a stricture increases the risk of urinary incontinence. Analysis of data from the prostate cancer registry also revealed that older age, a larger prostate at the time of surgery, and a non-nerve-sparing procedure increase the risk of urinary incontinence.”
What benefits can this research provide for patients?
“Since we have identified factors that affect the risk of urinary incontinence, it would be beneficial to discuss these with patients when choosing surgical treatment.”
“Rewarding patient interaction”
What has been enjoyable and rewarding about your doctoral project?
“Research is a team effort. Collaboration with my co-authors has been incredibly rewarding. The absolute highlight, aside from working with radiologists and our urotherapists, has been reviewing the MR images. Because my research involves a clinical study, direct patient interaction has been very fulfilling. Clinical studies take a long time to conduct and rely on patients’ willingness to participate, and it requires acceptance that research takes time.”
Text: Jakob Lundberg