Bridge, Joshua; Labban, Muhieddine; Cole, Alexander P; Adebusoye, Busola; Smith, Sarah C; Protopapa, Evangelia; McCartan, Neil; Brew-Graves, Chris; Trinh, Quoc-Dien; Hamer, Kevin; +4 more... Mallett, Sue; van der Meulen, Jan; Moore, Caroline M; TrueNTH Post Surgery UK Investigators; (2024) Urinary and Sexual Impact of Robotic Radical Prostatectomy: Reporting of Patient-reported Outcome Measures in the First Year after Radical Prostatectomy in a Contemporary Multicentre Cohort in the United Kingdom. European urology open science, 64. pp. 11-21. ISSN 2666-1691 DOI: https://doi.org/10.1016/j.euros.2024.05.003
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Abstract
BACKGROUND AND OBJECTIVE: Radical prostatectomy (RP) is an established treatment for localised prostate cancer that can have a significant impact on urinary and sexual function, with recovery over time. Our aim was to describe functional recovery in the first year after RP, reporting descriptive outcomes alongside validated patient-reported outcome measure scores (Expanded Prostate Cancer Index Composite, EPIC-26). METHODS: Men undergoing RP between September 2015 and November 2019 completed EPIC-26 at baseline and 1, 3, 6, and 12 mo. KEY FINDINGS AND LIMITATIONS: Overall, 2030 men consented to participation, underwent RP, and completed EPIC-26. At baseline, 97% were pad-free (1928/1996; 95% confidence interval [CI] 96-97%) and 77% were leak-free and pad-free (1529/1996; 95% CI 75-78), with a median EPIC-26 incontinence domain score of 100 (interquartile range [IQR] 86-100). At 12 mo, 65% were pad-free (904/1388; 95% CI 63-68%) and 42% were leak-free and pad-free (583/1388; 95% CI 39-45%), with a median EPIC-26 score of 76 (IQR 61-100). While one in three men reported wearing a pad at 12 mo, fewer than one in ten men needed more than 1 pad/d. At baseline, 1.9% reported a "moderate or big problem" with urine leakage, which increased to 9.7% at 12 mo. At baseline, the median sexual domain score among 1880 men was 74 (IQR 43-92) and 52% had erections sufficient for intercourse without medication (975/1880; 95% CI 50-54%). Among these 975 men, 630 responded at 12 mo, of whom 17% reported sufficient erections for intercourse (105/630; 95% CI 14-20%), without medication in 6% (37/630; 95% CI 4-8%) and needing medication in 11% (68/630; 95% CI 9-13%); the median EPIC-26 domain score was 26 (IQR 13-57). CONCLUSIONS AND CLINICAL IMPLICATIONS: Reporting of functional outcomes after RP in terms of easily understood concepts such as pad-free and leak-free status, and erections with and with medication, alongside the classical report using EPIC-26 domain scores, increases the understanding of RP recovery patterns over the first year. PATIENT SUMMARY: At 12 months after surgery for prostate cancer, one in ten men reported a moderate or big problem with urine leakage and one in five men reported sufficient erections.
Item Type | Article |
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Faculty and Department | Faculty of Public Health and Policy > Dept of Health Services Research and Policy |
PubMed ID | 38812920 |
Elements ID | 225338 |
Official URL | https://doi.org/10.1016/j.euros.2024.05.003 |
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Filename: Bridge-etal-2024-Urinary-and-Sexual-Impact-of-Robotic-Radical-Prostatectomy.pdf
Licence: Creative Commons: Attribution 4.0
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