title: Factors predicting early and late phase decline of sexual health-related quality of life following radical prostatectomy.
abstract: BACKGROUND
  The association between early and late phase sexual health-related quality of life (HRQoL) following radical prostatectomy (RP) is unclear. Moreover, factors that predict either early or late sexual HRQoL decline have not been fully investigated.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the correlation between early and late phase sexual HRQoL decline, and identify clinical parameters that predict substantial sexual HRQoL decline after surgery in the early phase (3 months) and late phase (20 months) following RP.
  
  
  METHODS
  We analyzed data on 2,345 consecutive patients who underwent radical retropubic prostatectomy, radical perineal prostatectomy, or robotic-assisted laparoscopic prostatectomy between 2001 and 2009 from the Duke Prostate Center database.
  
  
  METHODS
  Sexual HRQoL was assessed using the Expanded Prostate Cancer Index Composite instrument at baseline, early and late phase after surgery. The Spearman rank test was used to calculate correlation coefficients between early and late phase sexual HRQoL decline. Logistic regression analysis was performed to identify factors associated with substantial sexual HRQoL decline during both phases.
  
  
  RESULTS
  Of 406 men who met our criteria, 217 (53.5%) men had normal erectile function, whereas 189 (46.5%) men had erectile dysfunction at baseline. Declines of sexual HRQoL during early phase had a significant association with that of a decline during late phase (r = 0.48, P < 0.001). In logistic regression, older age at surgery (odds ratio [OR], 1.06; P = 0.007 and OR, 1.08; P = 0.001), African-American race (OR, 4.32; P = 0.001 and OR, 3.13; P = 0.017), and overall comorbidity (OR, 1.43; P = 0.072 and OR, 1.72; P = 0.010) were consistently associated with substantial decline of sexual HRQoL in both early and late phases.
  
  
  CONCLUSIONS
  Sexual HRQoL at early and late phases after RP were strongly correlated. Additionally, several factors were identified to be a predictor for decline of sexual HRQoL. Our findings may be used to advise patients who possess aforementioned risk factors during both phases.
authors.affiliation: Division of Urologic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: Masaki
authors.initials: M
authors.lastname: Kimura
authors.forename: Lionel L
authors.initials: LL
authors.lastname: Bañez
authors.forename: Florian R
authors.initials: FR
authors.lastname: Schroeck
authors.forename: Leah
authors.initials: L
authors.lastname: Gerber
authors.forename: Jim
authors.initials: J
authors.lastname: Qi
authors.forename: Takefumi
authors.initials: T
authors.lastname: Satoh
authors.forename: Shiro
authors.initials: S
authors.lastname: Baba
authors.forename: Cary N
authors.initials: CN
authors.lastname: Robertson
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Walther
authors.forename: Craig F
authors.initials: CF
authors.lastname: Donatucci
authors.forename: Judd W
authors.initials: JW
authors.lastname: Moul
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Polascik
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D007172:Erectile Dysfunction / Q000209:etiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery; D011788:Quality of Life; D044469:Racial Groups; D012189:Retrospective Studies; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D013997:Time Factors