Quality of life after radical prostatectomy or watchful waiting.
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.
Steineck
Gunnar
G
Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden. gunnar.steineck@onkpat.ki.se
Helgesen
Fred
F
Adolfsson
Jan
J
Dickman
Paul W
PW
Johansson
Jan-Erik
JE
Norlén
Bo Johan
BJ
Holmberg
Lars
L
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