title: Quality of life in young men after radical prostatectomy.
abstract: Urinary and sexual function and bother are important outcomes following radical prostatectomy (RP). Since urinary and sexual function are age-related, post-operative bother may vary by age. This study explores the disease-specific quality-of-life outcomes in young men compared with older men undergoing RP. Using CaPSURE data, we identified men who underwent RP and completed the UCLA Prostate Cancer Index (PCI) before and 1-year post-RP. Men were stratified by age (< 55 years, 55-64, > or = 65). Multivariate regression models were created: a linear model for predictors of PCI scores and a logistic model for predictors of severe declines in PCI domains. Younger men scored significantly better than older men in urinary function (P=0.04), urinary bother (P=0.02) and sexual function (P<0.0001) 1-year post-RP. Severe declines in urinary bother (odds ratio (OR)=1.54, 1.01-2.35) and sexual function (OR=3.20, 1.97-5.19) were more common in men > or = 65 years. Men with relationships had less urinary bother (P=0.03) and were less likely to experience severe worsening of urinary bother (OR=0.32, 0.17-0.60) while having a greater risk of severe worsening of sexual bother (OR=2.74, 1.28-5.89). The use of sexual aids was associated with worse sexual bother (P<0.0001) and greater risk of severe worsening of sexual bother (OR=2.29, 1.54-3.30). Baseline PCI scores were independent predictors in all models. One year after RP, younger men (age < 55) have similar, or better, urinary and sexual function and bother. Baseline scores are strongly associated with post-RP scores and severity of declines. Current relationships and use of sexual aids have significant roles in post-RP bother.
authors.affiliation: Department of Urology, University of Washington School of Medicine, Seattle, WA 98195, USA. jlwright@u.washington.edu
authors.forename: J L
authors.initials: JL
authors.lastname: Wright
authors.forename: D W
authors.initials: DW
authors.lastname: Lin
authors.forename: J E
authors.initials: JE
authors.lastname: Cowan
authors.forename: P R
authors.initials: PR
authors.lastname: Carroll
authors.forename: M S
authors.initials: MS
authors.lastname: Litwin
mesh_terms: D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery*; D011788:Quality of Life; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D011795:Surveys and Questionnaires; D014555:Urination Disorders / Q000209:etiology