5-year urinary and sexual outcomes after radical prostatectomy: results from the Prostate Cancer Outcomes Study.
OBJECTIVE
Prior studies of postoperative outcomes following radical prostatectomy have been limited by selection bias and short-term followup. In this study we assessed temporal changes in urinary and sexual function up to 5 years following radical prostatectomy in a population based cohort.


METHODS
A sample of 1,288 men with localized prostate cancer who underwent radical prostatectomy and completed a baseline survey within 6 to 12 months of diagnosis were included in the analysis. Two and 5-year functional and quality of life data were collected, as was information on the use of erectile aids. Temporal functional changes and potentially confounding or modifying factors were assessed using longitudinal regression models.


RESULTS
Of these men 14% reported frequent urinary leakage or no urinary control 60 months after diagnosis, which was slightly higher than the 10% reporting incontinence at 24 months (p = 0.007). At 60 months 28% of the men had erections firm enough for intercourse compared with 22% at 24 months (p = 0.003). Sildenafil was the most commonly used erectile aid (43% ever used) and 45% of users reported that it helped "somewhat" or "a lot."


CONCLUSIONS
Urinary and sexual dysfunction were common 5 years following radical prostatectomy in this large, community based cohort of prostate cancer survivors. While a small minority of subjects experienced changes in urinary or sexual function between years 2 and 5 after prostatectomy, functional outcomes remained relatively stable in the majority of participants.
Penson
David F
DF
Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California 90089, USA. penson@usc.edu
McLerran
Dale
D
Feng
Ziding
Z
Li
Lin
L
Albertsen
Peter C
PC
Gilliland
Frank D
FD
Hamilton
Ann
A
Hoffman
Richard M
RM
Stephenson
Robert A
RA
Potosky
Arnold L
AL
Stanford
Janet L
JL