Health related quality of life before and after laparoscopic radical prostatectomy

Richard E. Link, Li Ming Su, Wendy Sullivan, Sam B. Bhayani, Christian P. Pavlovich

Research output: Contribution to journalArticle

Abstract

Purpose: The viability of laparoscopic radical prostatectomy (LRP) as a surgical treatment for prostate cancer depends on oncological and health related quality of life (HRQOL) outcomes. We present a prospective assessment of HRQOL in 122 patients before and after LRP using the validated Expanded Prostate Cancer Index Composite (EPIC) questionnaire. Materials and Methods: EPIC data were collected preoperatively, and at 3, 6 and 12 months after LRP, and all were normalized to patient preoperative baseline responses. Results: Using traditional single question responses, 93.4% of patients were continent (0 to 1 pads) at postoperative month 12. Of previously potent men who underwent bilateral nerve sparing 78.9% reported engaging in sexual intercourse within postoperative year 1. However, EPIC domain scores provided a more comprehensive assessment of functional outcomes. For the urinary incontinence subdomain, the majority of functional recovery was achieved by postoper-ative month 6, reaching a 74% return to baseline on average. In contrast, recovery of the sexual function subdomain continued throughout postoperative year 1 (to a mean of 64%). Recovery of sexual function was not significantly affected by age or preoperative potency status, although the extent of nerve sparing was a significant predictor of outcome (mean recovery to 75% of baseline for bilateral vs 36% for no nerve sparing at 12 months, p = 0.005). Conclusions: Nerve sparing LRP provides satisfactory first year HRQOL outcomes when assessed with a validated instrument. The time course and extent of functional recovery documented in this prospective study may prove useful for patient counseling before LRP.

Original languageEnglish (US)
Pages (from-to)175-179
Number of pages5
JournalJournal of Urology
Volume173
Issue number1
DOIs
StatePublished - Jan 2005

Keywords

  • Laparoscopy
  • Prostatectomy
  • Prostatic neoplasms
  • Quality of life

ASJC Scopus subject areas

  • Urology

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