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Health related quality of life before and after laparoscopic radical prostatectomy.
J Urol. 2005 Jan; 173(1):175-9; discussion 179.JU

Abstract

PURPOSE

The viability of laparoscopic radical prostatectomy (LRP) as a surgical treatment for prostate cancer depends on oncological and health related quality of life (HRQOL) outcomes. We present a prospective assessment of HRQOL in 122 patients before and after LRP using the validated Expanded Prostate Cancer Index Composite (EPIC) questionnaire.

MATERIALS AND METHODS

EPIC data were collected preoperatively, and at 3, 6 and 12 months after LRP, and all were normalized to patient preoperative baseline responses.

RESULTS

Using traditional single question responses, 93.4% of patients were continent (0 to 1 pads) at postoperative month 12. Of previously potent men who underwent bilateral nerve sparing 78.9% reported engaging in sexual intercourse within postoperative year 1. However, EPIC domain scores provided a more comprehensive assessment of functional outcomes. For the urinary incontinence subdomain, the majority of functional recovery was achieved by postoperative month 6, reaching a 74% return to baseline on average. In contrast, recovery of the sexual function subdomain continued throughout postoperative year 1 (to a mean of 64%). Recovery of sexual function was not significantly affected by age or preoperative potency status, although the extent of nerve sparing was a significant predictor of outcome (mean recovery to 75% of baseline for bilateral vs 36% for no nerve sparing at 12 months, p = 0.005).

CONCLUSIONS

Nerve sparing LRP provides satisfactory first year HRQOL outcomes when assessed with a validated instrument. The time course and extent of functional recovery documented in this prospective study may prove useful for patient counseling before LRP.

Authors+Show Affiliations

James Buchanan Brady Urological Institute, Johns Hopkins Bayview Medical Center, 600 North Wolfe Street, Jefferson Street Building, Baltimore, Maryland 21287, USA. rlink5@jhmi.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15592069

Citation

Link, Richard E., et al. "Health Related Quality of Life Before and After Laparoscopic Radical Prostatectomy." The Journal of Urology, vol. 173, no. 1, 2005, pp. 175-9; discussion 179.
Link RE, Su LM, Sullivan W, et al. Health related quality of life before and after laparoscopic radical prostatectomy. J Urol. 2005;173(1):175-9; discussion 179.
Link, R. E., Su, L. M., Sullivan, W., Bhayani, S. B., & Pavlovich, C. P. (2005). Health related quality of life before and after laparoscopic radical prostatectomy. The Journal of Urology, 173(1), 175-9; discussion 179.
Link RE, et al. Health Related Quality of Life Before and After Laparoscopic Radical Prostatectomy. J Urol. 2005;173(1):175-9; discussion 179. PubMed PMID: 15592069.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Health related quality of life before and after laparoscopic radical prostatectomy. AU - Link,Richard E, AU - Su,Li-Ming, AU - Sullivan,Wendy, AU - Bhayani,Sam B, AU - Pavlovich,Christian P, PY - 2004/12/14/pubmed PY - 2005/1/14/medline PY - 2004/12/14/entrez SP - 175-9; discussion 179 JF - The Journal of urology JO - J Urol VL - 173 IS - 1 N2 - PURPOSE: The viability of laparoscopic radical prostatectomy (LRP) as a surgical treatment for prostate cancer depends on oncological and health related quality of life (HRQOL) outcomes. We present a prospective assessment of HRQOL in 122 patients before and after LRP using the validated Expanded Prostate Cancer Index Composite (EPIC) questionnaire. MATERIALS AND METHODS: EPIC data were collected preoperatively, and at 3, 6 and 12 months after LRP, and all were normalized to patient preoperative baseline responses. RESULTS: Using traditional single question responses, 93.4% of patients were continent (0 to 1 pads) at postoperative month 12. Of previously potent men who underwent bilateral nerve sparing 78.9% reported engaging in sexual intercourse within postoperative year 1. However, EPIC domain scores provided a more comprehensive assessment of functional outcomes. For the urinary incontinence subdomain, the majority of functional recovery was achieved by postoperative month 6, reaching a 74% return to baseline on average. In contrast, recovery of the sexual function subdomain continued throughout postoperative year 1 (to a mean of 64%). Recovery of sexual function was not significantly affected by age or preoperative potency status, although the extent of nerve sparing was a significant predictor of outcome (mean recovery to 75% of baseline for bilateral vs 36% for no nerve sparing at 12 months, p = 0.005). CONCLUSIONS: Nerve sparing LRP provides satisfactory first year HRQOL outcomes when assessed with a validated instrument. The time course and extent of functional recovery documented in this prospective study may prove useful for patient counseling before LRP. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/15592069/Health_related_quality_of_life_before_and_after_laparoscopic_radical_prostatectomy_ L2 - https://www.jurology.com/doi/10.1097/01.ju.0000147190.67218.1b?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -