Prospective evaluation of the effects of prostatectomy on symptoms and quality of life.
OBJECTIVE
To evaluate prospectively urinary symptoms and quality of life before and after prostate surgery, among men who had been on a waiting list for elective transurethral prostate resection (TURP).


METHODS
Face-to-face interviews with 47 men before and after prostate surgery using the urinary symptom specific American Urological Association Urinary Symptom Index (AUA-7), the Short Form 36 Health Survey (SF-36), and questions relating to the effects of urinary symptoms on men's lives and acceptable waiting times for surgery.


RESULTS
The mean AUA-7 score before surgery for all participants was 22.2 (range 5-34) and after surgery improved to a mean of 7.3 (range 1-28). Men with severe urinary symptoms before surgery experienced the greatest improvement in symptoms after surgery, compared with the mild/moderate symptom group. Significant improvements occurred in three of the eight SF-36 dimensions following surgery. Acceptable waiting times for surgery differed according to the severity of mens' urinary symptoms.


CONCLUSIONS
Efforts to develop methods for prioritisation of access to surgery are supported. Men with mild or moderate symptoms may reasonably delay surgery, with the expectation that, if they develop more severe symptoms, surgery will be helpful. Because of the risks as well as the benefits of prostate surgery, the use of illustrative vignettes may be useful for clinicians advising patients.
Derrett
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Department of Preventive and Social Medicine, University of Otago, Dunedin. sarah.derrett@stonebow.otago.ac.nz
Paul
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Herbison
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D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D015276:Health Care Rationing; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D018579:Patient Selection; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods / Q000523:psychology*; D011470:Prostatic Hyperplasia / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery*; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014555:Urination Disorders / Q000209:etiology*; D014563:Urodynamics; D014850:Waiting Lists