Detailed analysis of patient-reported lower urinary tract symptoms and effect on quality of life after robotic radical prostatectomy

Jonathan J Aning; Kenneth R MacKenzie; Michael Fabricius; Elaine McColl; Mark I Johnson; Zafer Tandogdu; Naeem A Soomro; Christopher Harding

doi:10.1016/j.urolonc.2018.05.017

Detailed analysis of patient-reported lower urinary tract symptoms and effect on quality of life after robotic radical prostatectomy

Urol Oncol. 2018 Aug;36(8):364.e15-364.e22. doi: 10.1016/j.urolonc.2018.05.017. Epub 2018 Jun 9.

Authors

Jonathan J Aning¹, Kenneth R MacKenzie², Michael Fabricius³, Elaine McColl³, Mark I Johnson², Zafer Tandogdu⁴, Naeem A Soomro⁵, Christopher Harding⁶

Affiliations

¹ Department of Urology, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK. Electronic address: jonathan.aning@nuth.nhs.uk.
² Department of Urology, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
³ Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
⁴ Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK.
⁵ Department of Urology, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK.
⁶ Department of Urology, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.

PMID: 29891407
DOI: 10.1016/j.urolonc.2018.05.017

Abstract

Objective: To prospectively evaluate short- to medium-term patient-reported lower urinary tract symptoms (LUTS) and their effect on health-related quality of life (HRQoL) using validated questionnaires in a large cohort of patients following robotic-assisted radical prostatectomy (RARP) for prostate cancer.

Materials and methods: HRQoL and LUTS outcomes were prospectively assessed in 357 consecutive men undergoing RARP at a single center from 2012 to 2015 using the functional assessment of cancer therapy-prostate (FACT-P) and the international consultation on incontinence modular questionnaire-male LUTS (ICIQ-MLUTS). Questionnaires were administered at baseline, 6, 12, and 18 months. Data were analyzed using paired t-tests and ANOVA.

Results: Questionnaire completion rates were high (over 60% of eligible men completed 18-month follow-up). Mean Total FACT-P did not significantly change after RARP: 125.95 (standard deviation [SD] = 19.82) at baseline and 125.86 (SD = 21.14) at 18-months (P = 0.55). Mean total ICIQ-MLUTS also remained unchanged: 18.69 (SD = 10.70) at baseline and 18.76 (SD = 11.33) at 18-months (P = 0.11). Mean voiding score significantly reduced from 10.34 (SD = 5.78) at baseline to 6.33 (SD = 3.99) at 6 months after RARP (P<0.001). A reciprocal significant increase in storage score was observed: 5.34 (SD = 4.26) at baseline, 9.65 (SD = 5.71) at 6 months (P<0.001). Subanalyses of ICIQ-MLUTS scores revealed increases in storage symptoms were exclusively within urinary incontinence domains and included significant increases in both urge and stress urinary incontinence scores.

Conclusion: Overall, patient-reported outcome measures evaluating HRQoL and LUTS do not significantly change after RARP. Detailed analysis reveals significant changes within LUTS domains do occur after surgery which could be overlooked if only total LUTS scores are reported.

Keywords: Lower urinary tract symptoms; Prostate cancer; Quality of life; Robotic radical prostatectomy.

MeSH terms

Aged
Humans
Lower Urinary Tract Symptoms / etiology*
Lower Urinary Tract Symptoms / pathology
Male
Middle Aged
Prostatectomy / adverse effects*
Prostatectomy / methods
Quality of Life / psychology*
Robotic Surgical Procedures / adverse effects*
Robotic Surgical Procedures / methods