PATIENTS AND METHODS: A population-based random sample was drawn from the 20% Medicare claims files for August 1, 2008, through December 31, 2008. Participants had hospital and physician claims for radical prostatectomy and diagnostic codes for prostate cancer and reported undergoing either a robotic or open surgery. They received a mail survey that included self-ratings of problems with continence and sexual function a median of 14 months postoperatively.
RESULTS: Completed surveys were obtained from 685 (86%) of 797 eligible participants, and 406 and 220 patients reported having had robotic or open surgery, respectively. Overall, 189 (31.1%; 95% CI, 27.5% to 34.8%) of 607 men reported having a moderate or big problem with continence, and 522 (88.0%; 95% CI, 85.4% to 90.6%) of 593 men reported having a moderate or big problem with sexual function. In logistic regression models predicting the log odds of a moderate or big problem with postoperative continence and adjusting for age and educational level, robotic prostatectomy was associated with a nonsignificant trend toward greater problems with continence (odds ratio [OR] 1.41; 95% CI, 0.97 to 2.05). Robotic prostatectomy was not associated with greater problems with sexual function (OR, 0.87; 95% CI, 0.51 to 1.49).
CONCLUSION: Risks of problems with continence and sexual function are high after both procedures. Medicare-age men should not expect fewer adverse effects following robotic prostatectomy.
Written by:
Barry MJ, Gallagher PM, Skinner JS, Fowler FJ Jr. Are you the author?
Massachusetts General Hospital; University of Massachusetts; Foundation for Informed Medical Decision Making, Boston, MA; Dartmouth College and The Dartmouth Institute for Health Policy & Clinical Practice, Hanover, NH.
Reference: J Clin Oncol. 2012 Jan 3. Epub ahead of print.
doi: 10.1200/JCO.2011.36.8621
PubMed Abstract
PMID: 22215756
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