Sequelae of radical prostatectomy

Jønler, Morten; Messing, Edward M.; Rhodes, Patsy R.; Bruskewitz, Reginald C.

doi:10.1111/j.1464-410x.1994.tb16626.x

Cited by 109 publications

(41 citation statements)

References 10 publications

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“…In a smaller survey of similarly aged men (mean 65 y) from one private practice, Lim et al 8 noted a 43% incontinence rate (any degree) and only 4% of patients had spontaneous erections suf®cient for vaginal penetration. Jonler et al 13 noted a 74% rate of incontinence after RP with 34% noting that dripping was a signi®cant problem. Lim et al 8 found that 82 out of 89 (92%) surveyed patients would choose RP again, in line with our rate of 81.1%.…”

Section: Discussionmentioning

confidence: 99%

Preoperative and operative factors to predict incontinence, impotence and stricture after radical prostatectomy

Kao

et al. 1998

Prostate Cancer Prostatic Dis

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The purpose of this study was to determine the incidence of patient-self reported post prostatectomy incontinence, impotence, bladder neck contracture or stricture, better, same or worse quality of life and willingness for same treatment again in a large group of radical prostatectomy (RP) patients and to determine if these morbidities are predictable with demographic, surgical or prostate cancer (PC) factors. Methods: A patient self-reporting questionnaire was completed and returned by 374 out of 458 eligible (81.7%) RP patients from one center, 267 (72.2%) have been operated since 1990 and all of whom were a minimum six month postoperative (75%b1 y). Questionnaire results were independently analyzed by a third party and correlated to demographic, operative, and tumor factors in an ongoing comprehensive PC database. Results: The patient self-reported incidence of post prostatectomy incontinence (any degree), impotence, and bladder neck contracture or stricture was 72.2, 87.4, and 25.9%, respectively. The reported rate of incontinence requiring protection was 39.0% and only 2.4% had persistent bladder neck contracture/stricture. Pathologic stage (continuous variable) was the only factor to signi®cantly predict incontinence and no factor could predict impotence or bladder neck contracture/ stricture in univariate analysis. No factor was predictive of morbidity by multivariate analysis. Despite incontinence and impotence signi®cantly affecting QOL self-reporting (P 0.001, 0.001, respectively) and willingness to undergo RP again (P 0.001, 0.067, respectively), the majority of patients would choose surgery again. Conclusions: Although radical prostatectomy morbidity is common and affects patient-reported overall QOL, most patients would choose the same treatment again. Demographic, preoperative, operative, and tumor factors did not reliably predict patient-reported morbidity in this series.

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Section: Discussionmentioning

confidence: 99%

Preoperative and operative factors to predict incontinence, impotence and stricture after radical prostatectomy

Kao

et al. 1998

Prostate Cancer Prostatic Dis

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“…Rates of ED after radical prostatectomy have been reported in the literature ranging from 29 to 91%. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] The rates of ED after conventional radiation therapy range from 40 to 65%, [22][23][24][25][26][27] and the rates of ED after brachytherapy range from 16 to 50%. 28 The true etiology of ED after radiation therapy remains controversial.…”

Section: Introductionmentioning

confidence: 99%

An analysis of erectile function after intensity modulated radiation therapy for localized prostate carcinoma

Brown

Brooks

Albert

et al. 2006

Prostate Cancer Prostatic Dis

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Radiation therapy for prostate cancer can cause erectile dysfunction (ED). Intensity Modulated Radiation Therapy (IMRT) can reduce the amount of radiation to surrounding tissues associated with ED. We characterize the incidence of and factors associated with ED in prostate cancer patients after IMRT at the National Naval Medical Center (NNMC). Patients potent by definition of the Sexual Health Inventory for Men (SHIM) before treatment completed the specific erectile questions of the SHIM after IMRT. Statistical analyses were performed to examine the relationships between several factors and ED. Thirty-two of 45 patients with mean age of 68.2 years (50-86 years) completed the SHIM. The median follow-up was 36.8 months (16-63.6 months) as defined by the time from completion of therapy to reassessment with the SHIM. Eight of 32 patients (25%) had no post-treatment ED (SHIM score 22-25), three of 32 (9%) had mild post-treatment ED (SHIM score 17-21), five of 32 (16%) had mild to moderate ED (SHIM score 12-16), five of 32 (16%) had moderate ED (SHIM score 8-11) and 11 of 32 (34%) had severe post-treatment ED (SHIM scoreo8). Posttreatment potency was significantly associated with the pre-treatment SHIM score (P ¼ 0.001) and history of hypertension (P ¼ 0.03). The mean radiation dose to the penile bulb and volume of penile bulb treated were not associated with post-treatment potency (P ¼ 0.38, 0.76, respectively). IMRT maintains potency in the majority of patients. This analysis compares favorably in preserving erectile function to previously reported series using conventional external beam radiation therapy techniques. The dose of radiation received by the penile bulb and volume of penile bulb were not associated with post-treatment ED in this analysis.

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“…Table 2 shows the results of recent patient-reported outcome surveys at least 1 year after radical prostatectomy or radiation therapy. [4][5][6][7][8][9][10][11][12][13][14][15][16][17] Not surprisingly, incontinence and impotence occur at higher rates than those typically reported in the literature. For example, incontinence after radical surgery has been reported by physicians to vary between 5% and 10%; 18 however, patient reports of incontinence requiring pads are much more common.…”

Section: Localized Prostate Cancermentioning

confidence: 72%

Quality of life in prostate cancer patients

Herr

1997

CA: A Cancer Journal for Clinicians

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Sequelae of radical prostatectomy

Abstract: Using this survey instrument, we found adverse sequelae of radical prostatectomy to be surprisingly high. However, patients were generally satisfied with their decision to undergo surgery.

Cited by 109 publications

References 10 publications

Preoperative and operative factors to predict incontinence, impotence and stricture after radical prostatectomy

Preoperative and operative factors to predict incontinence, impotence and stricture after radical prostatectomy

An analysis of erectile function after intensity modulated radiation therapy for localized prostate carcinoma

Quality of life in prostate cancer patients

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