Patient-reported urinary continence and sexual function after anatomic radical prostatectomy

Walsh, Patrick C.; Marschke, Penny; Ricker, Deborah D.; Burnett, Arthur L.

doi:10.1016/s0090-4295(99)00397-0

Cited by 615 publications

(389 citation statements)

References 14 publications

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“…13 Thus, our contention that post-RRP incontinence should be different in patients with different body sizes. Our data, however, refutes this theory.…”

Section: Discussionmentioning

confidence: 88%

Urinary incontinence after radical retropubic prostatectomy is not related to patient body mass index

Mulholland

Huynh

Huang

et al. 2006

Prostate Cancer Prostatic Dis

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To determine if a relationship exists between patient body habitus and urinary incontinence after radical retropubic prostatectomy (RRP) for clinically localized prostate cancer. A questionnaire developed by combining parts of lower urinary tract symptom questionnaires concerning voiding symptoms after RRP was mailed to 268 consecutive patients who underwent RRP over a 2-year period. The interval between surgery and questionnaire administration was greater than 24 months for each patient. No interval was greater than 54 months. The questionnaire attempted to overcome the subjectivity of patient documented urinary incontinence by probing different aspects of each patient's voiding symptoms. Body mass index (BMI), obtained from preoperative anesthesia records, was used as the measurement for body habitus. Pearson correlations were used to determine relationships between BMI and responses and the independent t-test was used to determine differences between grouped responses and BMI. One hundred and eighty-two of 268 (68%) questionnaires were returned. No relationship was detected between BMI and patient estimates of urinary control, QOL relating to urinary symptoms, severity of stress incontinence, or use of protection (pad use). As well, no statistically significant relationship was found between BMI and a patient's willingness to undergo RRP again, based on his voiding symptoms, if given the choice. In conclusion, although patient body habitus may be related to other clinical outcomes following RRP, there does not appear to be a relationship of BMI to post-RRP urinary incontinence.

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“…13 Thus, our contention that post-RRP incontinence should be different in patients with different body sizes. Our data, however, refutes this theory.…”

Section: Discussionmentioning

confidence: 88%

Urinary incontinence after radical retropubic prostatectomy is not related to patient body mass index

Mulholland

Huynh

Huang

et al. 2006

Prostate Cancer Prostatic Dis

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show abstract

“…Third, although the median followup is 26 months, the range spans 4-59 months; the recovery may not have been fully appreciated at the time of survey for those treated more recently. The literature reports that physiological recovery from radical prostatectomy takes up to 18 months 26 and approximately 12 months for cryoablation. 27,28 However, time to recover on a psychological or emotional level is more elusive, especially taking into account recovery of the couple as a unit.…”

Section: Discussionmentioning

confidence: 99%

Concordance in the perception of couples recovering from primary surgical treatment of prostate cancer

et al. 2009

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Although prostate cancer affects men, research shows effects on both members of the couple. We analyzed concordance in couples recovering from primary surgical treatment of prostate cancer when surveyed on psychological domains including emotional status, relationship, selfimage, partnership quality and support. Retrospective Sexual Surveys were utilized to survey physiological changes as well as psychological effects. In total, 28 heterosexual couples (56 people) were enrolled. Patients were treated between February 2002 and March 2007 with a median followup of 26 (range: 4-59) months. When polled on psychological aspects that may have been affected by treatment, overall concordance was 75.0%. Partnership had the highest concordance (92.2%) with treatment satisfaction questions following in second (90.7%). Subcategories focused on self-image (77.5%), relationship (67.3%), support (66.4%) and emotional status (55.6%), were less concordant. Although couples report relationships as strong and team-like, misconception between partners is widespread. Further research with regards to the effect of such disparities in couples might provide additional insight into improving recovery.

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“…18 In fact, even under the best of nerve-sparing conditions, some nerve damage is inevitable due to the proximity of the nerves to the prostate gland and the traction damage incurred during surgery. 4 Even though it may be temporary, this damage may lead to denervation atrophy of the corpora cavernosa, which in turn leads to at least temporary ED.…”

Section: Pathophysiologymentioning

confidence: 99%

“…[4][5][6][7] Furthermore, the exact definition of potency varies across studies. It is not surprising that sexual dysfunction is considered the most pressing quality of life issue 2 years after prostate surgery.…”

Section: Introductionmentioning

confidence: 99%

The role of vacuum erection devices in penile rehabilitation after radical prostatectomy

Lehrfeld

Lee

2009

Int J Impot Res

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Even nerve-sparing radical prostatectomy damages the cavernous nerves and leads to temporary erectile dysfunction (ED) in men recovering from prostate cancer surgery. Historically, patients recovering from prostate cancer surgery have been advised that the return of erectile function (EF) can take from 6 to 18 months, or even longer. Unfortunately, the return of sexual function in these patients remains variable, but is generally thought to be dependent on the individual patient's pre-surgery EF, as well as the degree of cavernous nerve disruption during prostate removal. Recently, there has been a growing movement to proactively treat patients postoperatively for presumed nerve damage to stimulate nerve recovery and possibly reduce the degree of irreversible damage. This would reduce the on-demand therapy these patients would require, and hopefully remove the requirement for an implantable prosthesis. The underlying hypothesis is that the artificial induction of erections shortly after surgery facilitates tissue oxygenation, reducing cavernosal fibrosis in the absence of nocturnal erections, potentially increasing the likelihood of preserving EF. Vacuum erection devices (VED), because of their ability to draw blood into the penis regardless of nerve disturbance, have become the centerpiece of penile rehabilitation protocols. This review will discuss the pathophysiology of radical prostatectomy induced ED and the rationale for rehabilitation. It will then discuss current protocols, including those involving the VED.

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Patient-reported urinary continence and sexual function after anatomic radical prostatectomy

Cited by 615 publications

References 14 publications

Urinary incontinence after radical retropubic prostatectomy is not related to patient body mass index

Urinary incontinence after radical retropubic prostatectomy is not related to patient body mass index

Concordance in the perception of couples recovering from primary surgical treatment of prostate cancer

The role of vacuum erection devices in penile rehabilitation after radical prostatectomy

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