Long-term functional outcome analysis in a large cohort of patients after radical prostatectomy

IntroductionGoal of the study was an analysis of functional outcomes after radical prostatectomy (RP) in a large cohort of patients. MethodsFunctional outcomes were assessed with the ICIQ-SF questionnaire and daily pad-usage for the evaluation of stress urinary incontinence (SUI) as well as with the IIEF-5 score for the evaluation of erectile dysfunction (ED). Statistical analysis included log-rank test, Mann-Whitney-Test, ANOVA test and logistic regression (P<0.05). ResultsIn total 4003 patients were included in the study. Median follow-up was 42 months (min. 2-max. 147 mo.). Regarding ED, an IIEF-5 score of 20 was reached by 39% of patients. Regarding SUI, 55% stated that they needed no pads, 21% of patients needed one pad per day. 33% of patients reported of no incontinence (0 p. in ICIQ), 26% of patients reported of a mild incontinence (1-5 p. in ICIQ). Patient global impression of their overall health respectively patient subjective quality of life were assessed with the EORTC QLC-C30 and were both high with a median of six points (on a scale of 1-7). In multivariate analysis time since surgery could be identified as independent risk factors on QOL (P=0.0028), IIEF-5 (P=0.0149), ICIQ (P<0.001), and pads per day (P<0.001). ConclusionsOur data show a good continence status, a clearly impaired erectile function but overall a good quality of life after surgery. In summary older patientswith an advanced tumor and adjuvant radiation therapywere at highest risk for an impaired functional outcome.