Short- and Long-term Functional Outcomes and Quality of Life after Radical Prostatectomy: Patient-reported Outcomes from a Tertiary High-volume Center

Raisa S Pompe; Zhe Tian; Felix Preisser; Pierre Tennstedt; Burkhard Beyer; Uwe Michl; Markus Graefen; Hartwig Huland; Pierre I Karakiewicz; Derya Tilki

doi:10.1016/j.euf.2017.08.001

Short- and Long-term Functional Outcomes and Quality of Life after Radical Prostatectomy: Patient-reported Outcomes from a Tertiary High-volume Center

Eur Urol Focus. 2017 Dec;3(6):615-620. doi: 10.1016/j.euf.2017.08.001. Epub 2017 Aug 30.

Authors

Affiliations

¹ Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada.
² Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada.
³ Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
⁴ Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany. Electronic address: d.tilki@uke.de.

PMID: 28869202
DOI: 10.1016/j.euf.2017.08.001

Abstract

Background: Results from population-based studies and the Prostate Testing for Cancer and Treatment trial reported worse urinary continence (UC) and erectile function (EF) for radical prostatectomy (RP) patients compared with their radiation or active surveillance counterparts.

Objective: To investigate functional outcomes for patients undergoing RP in a high-volume center.

Data, setting, and participants: A total of 8573 consecutive RP patients (2008-2012) were analyzed.

Intervention: RP.

Outcome measurements and statistical analysis: Standardized questionnaires assessing EF, UC, and quality of life (QoL), were completed at baseline and annually thereafter. UC was defined as use of 0 or 1 safety pad/d, whereas the regular use of 1 pad/d was considered incontinent. EF was defined as ≥3 points in the International Index of Erectile Function question two. QoL was assessed using the EORTC-QLQ-C30 Global Health/QoL item. Statistics relied on comparison of means and proportions.

Results and limitations: EF and UC rates significantly decreased after RP. Overall, 12-mo, 24-mo, and 36-mo EF rates were 45%, 51%, and 53%, but reached up to 65.7% in preoperatively potent patients with bilateral nerve sparing. At 36 mo, 13% reported problems in their partnership. However, at the same time point, 77% were satisfied with their sexual intercourse. UC rates were 89.1%, 91.3%, and 89.0% at 12-mo, 24-mo, and 36-mo postoperatively. Mean EORTC-QLQ-C30 scores ranged from 74 to 79 and remained constant compared to baseline.

Conclusions: Although varying definitions hinder direct comparisons to other studies, functional outcomes seemed favorable for patients undergoing RP in a high-volume center and most patients reported excellent QoL.

Patient summary: Results of functional outcomes (urinary continence and potency) after radical prostatectomy are better in a high-volume center compared with those obtained from population-based data, and most patients report excellent quality of life after radical prostatectomy.

Keywords: Functional outcome; Prostate cancer; Quality of life; Radical prostatectomy; Urinary continence.

MeSH terms

Aged
Coitus / psychology
Erectile Dysfunction / etiology
Humans
Interpersonal Relations
Male
Middle Aged
Organ Sparing Treatments / methods
Organ Sparing Treatments / psychology
Patient Reported Outcome Measures
Penile Erection / psychology
Postoperative Complications / etiology
Prostatectomy / methods*
Prostatectomy / psychology
Prostatic Neoplasms / psychology
Prostatic Neoplasms / surgery*
Quality of Life*
Sexual Partners / psychology
Tertiary Care Centers
Trauma, Nervous System / prevention & control
Treatment Outcome
Urinary Incontinence / etiology