Impact of radical perineal prostatectomy on urinary continence and quality of life: a longitudinal study of Japanese patients.
OBJECTIVE
We used self-completed questionnaires to obtain a longitudinal assessment of urinary continence and urinary, bowel, and sexual domain-related quality of life (QOL) in Japanese patients undergoing radical perineal prostatectomy (RPP).


METHODS
A total of 41 Japanese patients with a median age of 69 years who underwent RPP between February 2002 and February 2004 were included in the study. We measured QOL by the University of California, Los Angeles, Prostate Cancer Index (UCLA-PCI) and assessed urinary continence on the basis of three different definitions of continence. The International Prostate Symptom Score (I-PSS) was also included to evaluate lower urinary tract symptoms (LUTS).


RESULTS
When urinary continence was de fi ned as none, one, or two protective pads per day, 100%, 73%, 94%, 97%, or 100% of the patients were continent before, and 1, 3, 6, and 12 months after, RPP, respectively. When it was de fi ned as total control or occasional dribbling, the corresponding values were 97%, 70%, 84%, 94%, and 97%. Urinary function returned to the preoperative baseline level by 6 months postoperatively and scores for urinary bother had significantly surpassed the baseline by 12 months (P = 0.043). The I-PSS was significantly improved (P = 0.014), with a mean 4.7-unit decrease. Sexual function worsened significantly after surgery, and its recovery was less favorable. No significant change was observed in scores for bowel function or bowel bother.


CONCLUSIONS
The majority of patients who undergo RPP rapidly regain urinary continence and QOL within 3-6 months. RPP has a favorable impact on LUTS.
Matsubara
Akio
A
Department of Urology, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan. matsua@hiroshima-u.ac.jp
Yasumoto
Hiroaki
H
Mutaguchi
Kazuaki
K
Mita
Koji
K
Teishima
Jun
J
Seki
Mitsuhiro
M
Kajiwara
Mitsuru
M
Kato
Masao
M
Shigeta
Masanobu
M
Usui
Tsuguru
T
D000367:Age Factors; D000368:Aged; D006801:Humans; D007564:Japan; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods*; D011788:Quality of Life; D020127:Recovery of Function / Q000502:physiology*; D012735:Sexual Dysfunction, Physiological / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000503:physiopathology* / Q000523:psychology