Patient self-reporting questionnaire on urological morbidity and bother after radical retropubic prostatectomy.
OBJECTIVE
We assessed the incidence of morbidity and bother on quality-of-life (QL) after radical retropubic prostatectomy for prostate cancer.


METHODS
At least 12 months after surgery, self-reporting questionnaires were completed and returned by 368 (77.8%) of 473 eligible patients. Surgery related morbidity was evaluated by adhoc constructed questions. QL was assessed by the European Organization for Research and Treatment of Cancer QL core questionnaire (EORTC QLQ-C30). Multivariate and univariate analysis as well as regression analysis were used to assess the bother factors.


RESULTS
Postoperative urinary incontinence significant enough for the patient to use some kind of protection was reported by 27.2%. After surgery, 14.2% of preoperative potent men were able to get and maintain an erection sufficient enough for sexual intercourse without any aid. Overall 10.6% of respondents had undergone surgery for anastomotic stricture and 23.6% reported on adjuvant therapy. Furthermore, 43.2% reported on fear of not being cured from cancer. Postoperative urinary incontinence and fear of not being cured were associated with significant lower global QL scores and turned out as independent predictors for global QL. In contrast, postoperative erectile dysfunction, anastomotic stricture and adjuvant therapy were not independent predictors. In addition, 82.1% would vote for surgery again.


CONCLUSIONS
The majority of the patients would opt for surgical treatment again, although morbidity is common after radical prostatectomy and may impair QL. Particularly urinary incontinence and fear of not being cured are independent predictors for global QL after surgery. Therefore, surgical techniques with a low morbidity are requested as well as some kind of psychological support in order to cope with existential fear.
Augustin
Herbert
H
Department of Urology, Karl-Franzens-University Graz, Auenbruggerplatz 7, A 8036, Graz, Austria. herbert.augustin@utanet.at
Pummer
Karl
K
Daghofer
Fedor
F
Habermann
Helga
H
Primus
Günter
G
Hubmer
Gerhart
G
D000368:Aged; D000704:Analysis of Variance; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D015999:Multivariate Analysis; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D011471:Prostatic Neoplasms / Q000601:surgery*; D011788:Quality of Life; D012044:Regression Analysis; D012650:Self Disclosure; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014525:Urethral Stricture / Q000453:epidemiology / Q000209:etiology; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology; D014570:Urologic Diseases / Q000453:epidemiology* / Q000209:etiology*