title: Five-year longitudinal effect of radical perineal prostatectomy on health-related quality of life in Japanese men, using general and disease-specific measures.
abstract: OBJECTIVE
  To investigate the longitudinal alteration of health-related quality of life (HRQL) up to 5 years after radical perineal prostatectomy (RPP) among Japanese patients with localized prostate cancer.
  
  
  METHODS
  In all, 194 patients who had RPP were included in this longitudinal survey. The validated RAND 36-Item Health Survey (SF-36) and the University of California, Los Angeles Prostate Cancer Index (UCLA-PCI) were used to evaluate the HRQL.
  
  
  RESULTS
  Among the UCLA-PCI urinary domains, urinary function scores decreased at 3 months after RPP, but they increased 6 months after RPP. Likewise, urinary bother showed a transient decrease at 3 months, but had returned to the baseline level 6 months after RPP. Sexual function (SF) was drastically decreased at 3 months after RPP, but had slightly increased 1 year after RPP. Patients who had a nerve-sparing (NS) RPP showed better SF-related HRQL than those who did not at 6 months after RPP. This favourable alteration involving SF-related HRQL was closely associated with the NS procedure, but not with the patient age. Multivariate analysis showed that later recovery of SF was essentially related to the use of NS RPP, while early recovery of sexual bother was closely related to the patient age.
  
  
  CONCLUSIONS
  Our results confirmed the positive effect of RPP on the long-term HRQL in Japanese patients. Although NS surgery conferred the benefit of the recovery of SF, older Japanese patients were not greatly concerned about their decreased SF-related HRQL. The current results provide primary evidence for predicting the alteration of HRQL and understanding the effect of patient age and NS surgery on HRQL after RPP.
authors.affiliation: Departments of Urology, Shimane University School of Medicine, Izumo, Japan. inosyogo@med.shimane-u.ac.jp
authors.forename: Shogo
authors.initials: S
authors.lastname: Inoue
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shiina
authors.forename: Takeo
authors.initials: T
authors.lastname: Hiraoka
authors.forename: Koji
authors.initials: K
authors.lastname: Wake
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sumura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Honda
authors.forename: Shinji
authors.initials: S
authors.lastname: Urakami
authors.forename: Mikio
authors.initials: M
authors.lastname: Igawa
authors.forename: Tsuguru
authors.initials: T
authors.lastname: Usui