title: Quality of life after radical prostatectomy or watchful waiting.
abstract: BACKGROUND
  We evaluated symptoms and self-assessments of quality of life in men with localized prostate cancer who participated in a randomized comparison between radical prostatectomy and watchful waiting.
  
  
  METHODS
  Between 1989 and 1999, a group of Swedish urologists randomly assigned men with localized prostate cancer to radical prostatectomy or watchful waiting. In this follow-up study, we obtained information from 326 of 376 eligible men (87 percent) concerning certain symptoms, symptom-induced distress, well-being, and the subjective assessment of quality of life by means of a mailed questionnaire.
  
  
  RESULTS
  Erectile dysfunction (80 percent vs. 45 percent) and urinary leakage (49 percent vs. 21 percent) were more common after radical prostatectomy, whereas urinary obstruction (e.g., 28 percent vs. 44 percent for weak urinary stream) was less common. Bowel function, the prevalence of anxiety, the prevalence of depression, well-being, and the subjective quality of life were similar in the two groups.
  
  
  CONCLUSIONS
  The assignment of patients to watchful waiting or radical prostatectomy entails different risks of erectile dysfunction, urinary leakage, and urinary obstruction, but on average, the choice has little if any influence on well-being or the subjective quality of life after a mean follow-up of four years.
authors.affiliation: Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden. gunnar.steineck@onkpat.ki.se
authors.forename: Gunnar
authors.initials: G
authors.lastname: Steineck
authors.forename: Fred
authors.initials: F
authors.lastname: Helgesen
authors.forename: Jan
authors.initials: J
authors.lastname: Adolfsson
authors.forename: Paul W
authors.initials: PW
authors.lastname: Dickman
authors.forename: Jan-Erik
authors.initials: JE
authors.lastname: Johansson
authors.forename: Bo Johan
authors.initials: BJ
authors.lastname: Norlén
authors.forename: Lars
authors.initials: L
authors.lastname: Holmberg
mesh_terms: D000368:Aged; D007172:Erectile Dysfunction / Q000209:etiology; D005242:Fecal Incontinence / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D007410:Intestinal Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011468:Prostatectomy / Q000523:psychology; D011471:Prostatic Neoplasms / Q000150:complications* / Q000523:psychology / Q000601:surgery / Q000628:therapy*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000209:etiology; D014555:Urination Disorders / Q000209:etiology