Health-related quality of life (QOL) has become a pivotal criterion for assessing quality of specific therapy for prostate and bladder cancer in urology and serves increasingly as a basis for therapeutic decisions reached by urologists and patients. To aid in comprehension, we present the development of QOL research, the accumulated knowledge, and needs for further investigations by offering a broad review of the literature. In Germany, established inpatient rehabilitation has dealt with QOL for decades, but proof of efficacy was lacking. We clearly demonstrated in a prospective study the beneficial effects on QOL achieved with a specific modular urologic inpatient rehabilitation program after radical prostatectomy within 3-4 weeks and stability of these effects over time. Inpatient rehabilitation provides the best generic and disease-specific QOL after radical urologic surgery and completes the surgeon's performance.

Worldwide use of electrical stimulation for therapy of postoperative incontinence is based on a few prospective randomized controlled studies. We present a three-arm prospective randomized study evaluating physiotherapeutic pelvic floor training alone and in combination with transanal or perineal electrical stimulation. The study compared specific continence training (CT) and a combination of CT with transanal or perineal electrostimulation. The groups included 60 patients each and were analyzed with regard to self-assessment, objective characteristics of incontinence, standard quality of life questionnaire (QLQ-C 30), and recorded data of the stimulation device. The patients participated in a specific inpatient rehabilitation program and were assessed at the time of admittance, upon discharge, and again after 3 months. Significant improvement could be achieved in every group concerning urinary incontinence and quality of life. Additional use of electrical stimulation was significantly superior to physiotherapeutic training alone. However, these results could only be detected in a highly compliant subgroup. Analysis of device data indicated a high score of errors and lack of patient compliance. Perineal electrical stimulation was better accepted than transanal and showed less side effects and better outcome in the characteristics of incontinence. Improvement in the quality of life was mostly achieved during the weeks of inpatient rehabilitation. Electrical stimulation could not improve quality of life items. Electrical stimulation is an efficient instrument for treatment of postoperative high-grade incontinence, however, only with sufficient patient compliance.

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