Impact of Radical Prostatectomy on Urinary Incontinence, Erectile Dysfunction and General Quality of Life

João Paulo Zambon,Márcia Eli Girotti,Rogério Simonetti Alves,Silvana Aparecida Alves Corrêa,Fernando Gonçalves De Almeida,Sarita Mac Cornick

doi:10.4236/jbm.2015.38007

Abstract

The aims of this study were to evaluate the impact of radical retropubic prostatectomy on patient’s quality of life. Patients undergoing radical retropubic prostatectomy were followed for six months after surgery. We used quality of life questionnaires to study specific urinary symptoms and general health. WHOQOL-Bref (World Health Organization for Quality of Life) questionnaire was used to evaluate general health aspects, ICIQ-SF (International Consultation on Incontinence Questionnaire-Short Form), OABq (Overactive Bladder) and IPSS (International Prostatic Symptom Score) to evaluate incontinence and overactive bladder symptoms and Male Sexual Quotient to assess postoperative sexual dysfunctions. The questionnaires were scheduled before surgery, one, three and six months after surgery. Regarding the OAB-q scores, I-PSS and WHOQOL-Bref (physical, psychological, environmental, general, Question 1 and Question 2), symptoms worsened after one month if compared to preoperative symptoms. After six months, the WHOQOL’s social domain, the ICIQ-SF and QS-M scores remained worse if compared to preoperative evaluation. The incidence of sexual dysfunctions after six months was 0.83. In conclusion, urinary incontinence affects patient’s quality of life with gradual recovery after six months postoperatively. The social domain was the most common aspect affected by urinary incontinence. Our sexual dysfunction incidence was higher than other studies and this fact could be explained by many surgeries having been done by residents.

Highlights

Prostate cancer is the second most common type of tumor in Brazil and the sixth most common in the world
The complications of radical prostatectomy are well established and it is estimated that post-prostatectomy urinary incontinence (PPUI) occurs with 5% to 25% of patients and erectile dysfunction (ED) with 16% to 86% of patients, even if techniques for nerve bundles preservation are adopted during the surgical procedure [11]-[13]
When we analyze the domains of WHOQOL alone, we observe, that radical prostatectomy had a significant impact on the social domain, clearly associating erectile dysfunction with interpersonal relationship

Summary

Introduction

Prostate cancer is the second most common type of tumor in Brazil and the sixth most common in the world. This disease accounts for about 10% of all cancers cases and its incidence rate is about six times higher in developed countries than in developing countries [1] [2]. Patients diagnosed with localized prostate cancer have only the following treatment options: active surveillance, external beam radiotherapy, brachytherapy, and radical prostatectomy [9]. Radical prostatectomy is considered as a safe and effective treatment for localized prostate cancer [10]. The complications of radical prostatectomy are well established and it is estimated that post-prostatectomy urinary incontinence (PPUI) occurs with 5% to 25% of patients and erectile dysfunction (ED) with 16% to 86% of patients, even if techniques for nerve bundles preservation are adopted during the surgical procedure [11]-[13]

Objectives

Methods

Results

Discussion

Conclusion