The study is relevant, as survival rates for localized prostate cancer (CaP) are excellent, making quality of life (QOL) issues very important. This study is the first multi-center, prospective study to compare the issue. Seven German hospitals participated. Patients completed a questionnaire 1 day prior to surgery and every 3 months after surgery. Enrollment occurred between 2008 and 2009. The surgeries were performed by 2 surgeons at each center, each with more than 200 prostatectomies performed in the previous 5 years. Half of patients were between 61 and 70 years of age, but EERPE patients were significantly younger than RP patients, were better educated, and more often had a private health insurance. More men undergoing RP had a pelvic lymph node dissection and nerve-sparing operation. Three criteria were used to assess urinary continence - the use of protective pads in the amount of 0, or 1 (both equivalent to continent), or incontinent. Urge and stress incontinence and QOL were also assessed.
A total of 487 men were included in the final analysis; 237 had EERPE and 250 had RP. At 3 months after surgery, 44% of EERPE men and 40% of RP men had no need for any pads, and 66% and 63% respectively had no need for more than a single pad in a 24-hour period. A total of 39% of EERPE men and 46% of RP men assessed themselves as continent. There were no statistical differences for these comparisons. The patient self-assessments were worse than the quantitative assessment of pad usage. Symptoms of urge incontinence occurred in 52% and 53% of EERPE and RP patients. Symptoms of stress incontinence occurred in 61% and 66% of EERPE and RP patients. In total, 43% had symptoms of both urge and stress incontinence. The burden of urinary symptoms worsened at 3 months for both groups, regardless of nerve-sparing status. For patients who underwent a nerve-sparing procedure, 48% were completely continent at 3 months compared with 31% who did not undergo nerve sparing. Regarding age, 49% of men up to age 65 years were completely continent compared with 35% of men older than 65 years. No patients underwent additional continence surgery.
Koehler N, Gansera L, Stolzenburg JU, Rebmann U, Truss MC, Roth S, Scholz HJ, Fahlenkamp D, Thiel R, Liatsikos E, Braehler E, Holze S
Urol Oncol. 2011 Jun 28. Epub ahead of print
10.1016/j.urolonc.2010.10.013
PubMed Abstract
PMID: 21719324
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