5-Year Urinary and Sexual Outcomes After Radical Prostatectomy: Results From the Prostate Cancer Outcomes Study

Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California 90089, USA.
The Journal of urology (Impact Factor: 4.47). 06/2008; 179(5 Suppl):S40-4. DOI: 10.1016/j.juro.2008.03.136
Source: PubMed


Prior studies of postoperative outcomes following radical prostatectomy have been limited by selection bias and short-term followup. In this study we assessed temporal changes in urinary and sexual function up to 5 years following radical prostatectomy in a population based cohort.
A sample of 1,288 men with localized prostate cancer who underwent radical prostatectomy and completed a baseline survey within 6 to 12 months of diagnosis were included in the analysis. Two and 5-year functional and quality of life data were collected, as was information on the use of erectile aids. Temporal functional changes and potentially confounding or modifying factors were assessed using longitudinal regression models.
Of these men 14% reported frequent urinary leakage or no urinary control 60 months after diagnosis, which was slightly higher than the 10% reporting incontinence at 24 months (p = 0.007). At 60 months 28% of the men had erections firm enough for intercourse compared with 22% at 24 months (p = 0.003). Sildenafil was the most commonly used erectile aid (43% ever used) and 45% of users reported that it helped "somewhat" or "a lot."
Urinary and sexual dysfunction were common 5 years following radical prostatectomy in this large, community based cohort of prostate cancer survivors. While a small minority of subjects experienced changes in urinary or sexual function between years 2 and 5 after prostatectomy, functional outcomes remained relatively stable in the majority of participants.

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Available from: Ann S Hamilton
    • "As such, the number of men diagnosed with prostate cancer is increasing, and as men live for many years after diagnosis, their well-being and quality of life (QOL) after prostate cancer treatment are of great importance (Alfano et al., 2012; Eton and Lepore, 2002; Miller et al., 2005; Pardo et al., 2010; Penson et al., 2008a; Roth et al., 2008; Smith et al., 2009). Although prostate cancer survival rates are good, adverse effects of treatments impair QOL outcomes (Miller et al., 2005; Pardo et al., 2010; Penson et al., 2008a; Potosky et al., 2004; Smith et al., 2009). It is not clear whether the benefits of active treatments for early prostate cancer (prostatectomy, external beam radiation, "
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    ABSTRACT: Most cases of prostate cancer are diagnosed at an early stage, and men live for many years after diagnosis. Thus, their well-being and quality of life are of great importance. This study investigated patient experiences and psychological well-being in a Finnish national sample of prostate cancer patients who received various types of treatment. In a national sample (50%) of prostate cancer patients diagnosed in Finland in 2004, information was collected on the patients' experiences at diagnosis and choice of treatment (e.g. treatment selection, patient satisfaction with care and information, psychological reactions). In 2009, participants were asked about their experiences, and psychological well-being (psychological symptoms, satisfaction with life) was measured. In total, 1239 completed questionnaires (73%) were accepted for the study. Differences between treatments and predictors of psychological well-being were investigated using descriptive statistics and regression analysis. Half of the respondents were satisfied with the care and information they received about the cancer and side effects of treatment. Experiences and psychological well-being were most positive among patients who received brachytherapy and poorest among patients who received hormonal therapy. Patients who underwent prostatectomy or brachytherapy were most likely to have been involved in treatment selection. Negative experiences, such as learning of the diagnosis in an impersonal way and dissatisfaction with the information and care received, were predictive of poorer well-being. Unmet supportive care and informational needs were common. Experiences and well-being varied between treatments. Patients tended to prefer prostatectomy and brachytherapy. Unmet needs, which would probably be reduced by improvements in care, appear to have a long-lasting impact on patients' psychological well-being. Copyright © 2014 Elsevier Ltd. All rights reserved.
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    • "For patients with clinically localised PCa, radical prostatectomy (RP), particularly nerve-sparing radical prostatectomy (NS-RP), is the best choice treatment, with a life expectancy of ≥10 years2. However, despite the advancement in NS-RP, erectile dysfunction (ED) and urinary incontinence are still commonly encountered in these patients3. "
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    ABSTRACT: Prostate cancer (PCa) is the most common solid neoplasm diagnosed in developed countries. Nerve-sparing radical prostatectomy (NS-RP) has been widely accepted as the best choice treatment for localised PCa. However, erectile dysfunction (ED) and urinary incontinence are commonly observed after NS-RP. Using meta-analysis, we examined if phosphodiesterase type 5 inhibitors (PDE5-Is) could improve the symptoms of ED in patients undergoing NS-RP. This review contained seven randomised placebo-controlled trials with a total of 2,655 male patients. Patients in PDE5-Is group showed significant improvement in the International Index of Erectile Function-Erectile Function domain score (IIEF-EF), Global Assessment Questionnaire (GAQ), Sexual Encounter Profile question 2 (SEP-2) and SEP-3. Although the incidence of treatment-emergent adverse events (TEAEs) were high in both groups (56.44% vs. 40.63%), the safety profile were acceptable, with low incidence of discontinuation rate due to adverse events. Therefore, PDE5-Is are recommended for the treatment of post-NS-RP ED. Patients should be informed of possible adverse events.
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    • "Surgery is a major treatment modality for prostate cancer [1] and has been hypothesised to reduce mortality more than other treatments for localised prostate cancer [2]. However, the risks of surgery are known to include erectile dysfunction [3] even when nerve-sparing approaches are used [4]. Long-lasting sexual and urinary difficulties are the most common and troubling side-effects following radical prostatectomy [5] alongside loss of libido, ejaculatory dysfunction, orgasmic dysfunction and penile shortening [6]. "
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