title: Perioperative patient education improves long-term satisfaction rates of low-risk prostate cancer patients after radical prostatectomy.
abstract: OBJECTIVE
  To evaluate patient-reported functional outcomes after radical prostatectomy (RP) and to analyse the effect of perioperative patient education on satisfaction rates among low-risk prostate cancer patients.
  
  
  METHODS
  Inclusion criteria encompassed low-risk prostate cancer patients as defined by the D'Amico criteria, undergoing nerve-sparing RP without pelvic lymph node dissection. Patient-centred functional outcomes, subjective evaluation of perioperative counselling, and patient satisfaction rates were documented. Stress urinary incontinence (SUI) was assessed by daily pad usage. Erectile dysfunction (ED) was assessed using IIEF5 score. Patients' histories were attained from the electronic medical records. The effect of pre-defined predictive features for satisfaction rates was analysed in low-risk patients. Statistical analyses included Fisher's exact test, Mann-Whitney-U test, and binary logistic regression models (p < 0.05).
  
  
  RESULTS
  266 patients met the inclusion criteria. Median follow-up was 94 months (68-118). The global satisfaction rate was 75.1%. Regarding SUI, 69.5% of patients required no pads. 67.1% felt very well informed, while 11.7% felt poorly educated about postoperative SUI. Regarding ED, an IIEF score of ≥18 was reached by 33.7%. 59.6% felt very well educated, while 13.0% felt poorly informed. Poor patient counselling regarding SUI and ED led to significantly decreased long-term satisfaction rates [40.7, 33.3% (p < 0.001)]. In multivariate analysis, poor ED patient counselling [OR 0.190, 95% CI 0.055-0.652 (p = 0.008)], and postoperative IIEF5 score [OR 3.061, 95% CI 1.013-3.111 (p = 0.013)] could be confirmed as independent predictors for patient satisfaction.
  
  
  CONCLUSIONS
  Patient-centred functional outcome analysis has illustrated the importance of perioperative patient education on long-term patient satisfaction rates after RP in low-risk prostate cancer patients.
authors.affiliation: Department of Urology, Ludwig-Maximilians-University, Marchioninistrasse 15, 81377, Munich, Germany. Alexander.kretschmer@med.uni-muenchen.de.|Department of Urologic Sciences, The Vancouver Prostate Centre, University of British Columbia, 2660 Oak Street, Vancouver, BC, V6H3Z6, Canada. Alexander.kretschmer@med.uni-muenchen.de.
authors.forename: Alexander
authors.identifier: http://orcid.org/0000-0002-6511-4354
authors.initials: A
authors.lastname: Kretschmer
authors.affiliation: Department of Urology, Ludwig-Maximilians-University, Marchioninistrasse 15, 81377, Munich, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Buchner
authors.affiliation: Department of Urology, Ludwig-Maximilians-University, Marchioninistrasse 15, 81377, Munich, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Grabbert
authors.affiliation: Department of Urology, Ludwig-Maximilians-University, Marchioninistrasse 15, 81377, Munich, Germany.
authors.forename: Anne
authors.initials: A
authors.lastname: Sommer
authors.affiliation: Department of Urology, Ludwig-Maximilians-University, Marchioninistrasse 15, 81377, Munich, Germany.
authors.forename: Annika
authors.initials: A
authors.lastname: Herlemann
authors.affiliation: Department of Urology, Ludwig-Maximilians-University, Marchioninistrasse 15, 81377, Munich, Germany.
authors.forename: Christian G
authors.initials: CG
authors.lastname: Stief
authors.affiliation: Department of Urology, Ludwig-Maximilians-University, Marchioninistrasse 15, 81377, Munich, Germany.
authors.forename: Ricarda M
authors.initials: RM
authors.lastname: Bauer
mesh_terms: D000368:Aged; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D016015:Logistic Models; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010353:Patient Education as Topic; D000071066:Patient Reported Outcome Measures; D017060:Patient Satisfaction; D010388:Pelvis; D019990:Perioperative Care; D011183:Postoperative Complications / Q000453:epidemiology* / Q000523:psychology; D011468:Prostatectomy / Q000523:psychology; D011471:Prostatic Neoplasms / Q000523:psychology / Q000601:surgery*; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000453:epidemiology / Q000523:psychology
keywords: Erectile dysfunction; Patient education; Patient satisfaction; Prostate cancer; Radical prostatectomy; Stress urinary incontinence