Worse Urinary Function Research Articles

The effect of race on treatment patterns and subsequent health-related quality of life outcomes in men undergoing treatment for localized prostate cancer.

Racial differences in Health-Related Quality of Life (HRQoL) after treatment of prostate cancer (PCa) are not well studied. We compared treatment patterns and HRQoL in African American (AA) and non-AA men undergoing active surveillance (AS), radical prostatectomy (RP), or radiation (XRT). Men diagnosed with PCa from 2007-2017 in the Center for Prostate Disease Research Database were identified. HRQoL was evaluated using Expanded PCa Index Composite and SF-36 Health Survey. In 1006 men with localized PCa, 223 (22.2%) were AA (mean follow up 5.2 yrs). AA men with low-risk disease were less likely to undergo AS (28.5 vs. 38.8%) and more likely to undergo XRT (22.3 vs. 10.6%) than non-AA men, p < 0.001. In intermediate-risk disease, AA received more XRT (43.0 vs. 26.9%) and less RP (50.5 vs 66.8%), p = 0.016. In all men, RP resulted in worse urinary function and sexual HRQoL compared to AS and XRT. Bowel HRQoL did not vary by treatment in AA men, however, in non-AA men, XRT resulted in worse bowel scores than AS and RP. HRQoL was then compared for each treatment modality. AA men had worse sexual bother (p = 0.024) after RP than non-AA men, No racial differences were found in urinary, bowel, hormonal, or SF-36 scores for men undergoing AS, RP or XRT. AA men are less often treated with AS for low-risk disease and are more likely to undergo XRT. AA men experience worse sexual bother after RP, however, the effect of XRT on bowel symptoms is worse in non-AA men.

MP64-20 PREOPERATIVE MEMBRANOUS URETHRAL LENGTH IS ASSOCIATED WITH POST-PROSTATECTOMY URINARY FUNCTION IN ASIAN MEN

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy VI (MP64)1 Sep 2021MP64-20 PREOPERATIVE MEMBRANOUS URETHRAL LENGTH IS ASSOCIATED WITH POST-PROSTATECTOMY URINARY FUNCTION IN ASIAN MEN Spyridon Basourakos, Ashwin Ramaswamy, Miko Yu, Daniel Margolis, and Jim Hu Spyridon BasourakosSpyridon Basourakos More articles by this author , Ashwin RamaswamyAshwin Ramaswamy More articles by this author , Miko YuMiko Yu More articles by this author , Daniel MargolisDaniel Margolis More articles by this author , and Jim HuJim Hu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002104.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Studies demonstrate that Asian and African-American race (vs. white) and preoperative membranous urethral length (MUL) measured on MRI have been associated with post-radical prostatectomy (RP) urinary incontinence. However, the relationship of race and MUL has not been studied: this is noteworthy given improved patient selection as an approach to minimize the risk of post-RP incontinence. METHODS: We retrospectively identified men who self-identified as “Asian” and underwent robot-assisted RP for localized prostate cancer between 2015 and 2020. After appropriate training of two readers by an expert genitourinary radiologist, MULs were blindly measured by the two readers independently. Urinary function was assessed using the Expanded Prostate Cancer Index for Clinical Practice (EPIC-CP). Baseline clinicopathologic characteristic and imaging measurements were compared with Wilcoxon-Mann-Whitney and χ2 test. We used a generalized estimating equation (GEE) model to evaluate if Asian race is associated with urinary function recovery. RESULTS: There were no racial differences by age (66.8 95%CI 64.7-69.0 vs. 65.6, 95%CI 62.6-68.6; p=0.6), BMI (25.9, 95%CI 24.7-27.2 vs. 26.7, 95%CI 25.7-27.8; p=0.3), PSA (10.3, 95%CI 7.6-12.9 vs. 8.6, 95%CI 6.3-11.0; p=0.4), prostate volume (50.4, 95%CI 37.8-63.0 vs. 41.5, 95%CI 25.9-46.7; p=0.2) or complete nerve sparing status (86% vs. 86%; p=1.0). Asian men had shorter MUL (7.9mm, 95%CI 7.5–8.3 vs. 10.9mm, 95%CI 10.2–11.7; p<0.01) and worse EPIC-CP urinary function scores (3.82; 95%CI 2.47-5.17 vs. 1.95; 95%CI 1.11–2.79; p=0.022) at 12 months post-RP compared to non-Asians. Our GEE model demonstrated that Asian race is associated of a higher (worse) EPIC-CP urinary score when compared to non-Asians (parameter estimate 0.56; 95%CI 0.04-1.08; p=0.034). Furthermore, we found that lower MUL (p=0.03) and Asian race (p=0.036) were associated with increased 12-month EPIC-CP urinary function scores in a multivariate logistic model that included age and BMI. CONCLUSIONS: Asian race was associated with shorter MUL, and both Asian race and shorter MUL are independently associated with worse urinary function. Further confirmatory studies and comparative racial studies of MUL are necessary to better characterize disparities in outcomes. Source of Funding: Jim C. Hu receives research support from the Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust. Jim C. Hu also receives salary support from NIH R01 CA241758 and PCORI CER-2019C1-15682. The remaining authors report no further disclosures related to this work © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1118-e1118 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Spyridon Basourakos More articles by this author Ashwin Ramaswamy More articles by this author Miko Yu More articles by this author Daniel Margolis More articles by this author Jim Hu More articles by this author Expand All Advertisement Loading ...

Health-related quality of life overview after different curative treatment options in muscle-invasive bladder cancer: an umbrella review.

This umbrella review aims to evaluate the quality, summarize and compare the conclusions of systematic reviews investigating the impact of curative treatment options on health-related quality of life (HRQoL) in muscle-invasive bladder cancer (MIBC). The Cochrane Library, MEDLINE, Embase and Web of Science were searched independently by two authors from inception until 06 January 2020. Systematic reviews and meta-analyses assessing the impact of any curative treatment option on HRQol in MIBC patients were eligible. Risk of bias was assessed using the AMSTAR 2 tool. Thirty-two reviews were included. Robot-assisted RC with extracorporeal urinary diversion and open RC have similar HRQoL (n = 10). Evidence for pelvic organ-sparing RC was too limited (n = 2). Patients with a neobladder showed better overall and physical HRQoL outcomes, but worse urinary function in comparison with ileal conduit (n = 17). Bladder-preserving radiochemotherapy showed slightly better urinary and sexual but worse gastro-intestinal HRQoL outcomes in comparison with RC patients (n = 6). Quality of the reviews was low in more than 50% of the available reviews and most of the studies included in the reviews were nonrandomized studies. This umbrella review gives a comprehensive overview of the available evidence to date.

Gender and quality of life in bladder cancer.

464 Background: Quality of life among cancer survivors has been shown to vary by gender. Our objective was to evaluate differences in generic and bladder cancer-specific quality of life (QOL) based on gender among a large bladder cancer cohort. Methods: We performed a cross-sectional survey of bladder cancer patients using the Bladder Cancer Advocacy Network Patient Survey Network and Inspire platforms to determine generic and bladder cancer-specific QOL using the EORTC QLQ-C30 and Bladder Cancer Index. Patients were also queried regarding demographic, socioeconomic and clinical characteristics. The survey was advertised. We present descriptive statistics and a multiple linear regression model to identify factors independently associated with QOL domain score. Results: 972 respondents self-identified as patients with bladder cancer. Among respondents, 41% were female and 97% were white. The mean age was 67.6 years (range 29 to 93 years). Respondents were highly educated (67% completed college). 63% of patients identified as having non-invasive (NMIBC) cancer (n=578), 30% had MIBC (n=270), and 7% had metastatic bladder cancer (n=63). On multivariable analysis ( Table), female gender was significantly associated with worse generic QOL (p&lt;0.001), bowel function (p=0.001), and sexual function (p=0.02), and women trended toward worse urinary function (p=0.06), controlling for age, race, stage, comorbidity and years since diagnosis. Conclusions: Lower generic and domain-specific QOL scores are more common among female bladder cancer patients. Differential impact by gender may be important for the development of tailored interventions to improve QOL for bladder cancer patients. [Table: see text]

Toxicity and Quality of Life Outcomes from a Randomized Phase II Trial of HDR Monotherapy for Low and Intermediate-Risk Prostate Cancer

To report health-related quality of life (HRQOL) and toxicity outcomes at 4-years in prostate cancer patients treated with high-dose rate (HDR) brachytherapy as monotherapy using single-fraction of 19 Gy or 2 fractions of 13.5 Gy (27 Gy/2 fractions one week apart). Patients with low or intermediate-risk prostate cancer (NCCN definition) were accrued to a randomized phase II clinical trial of HDR brachytherapy as monotherapy, randomized to either 19 Gy/1 or 27 Gy/2. HRQOL (Expanded Prostate Cancer Index Composite [EPIC]), urinary symptoms (International Prostate Symptom Score [IPSS]), and toxicity (Common Terminology Criteria for Adverse Events [CTCAE], v4.0) were assessed prospectively. Comparison between the two arms was analyzed using Fisher exact test. Univariate linear and logistic regression analysis was used to investigate association between HRQOL/toxicity and baseline covariates. Median follow-up is 51 months. 170 patients were treated (87 with single 19 Gy, 83 with 27 Gy/2). Late (>6 months) GI toxicity was minimal in both arms, with G-2 toxicity <1%, and no difference between the arms. Late G-2 urinary toxicity was low and <2%, except for urinary frequency and incontinence. G-2 urinary frequency was similar between arms (19% for 19Gy/1 and 10% 27Gy/2; p=0.27). There was a significantly later G-2 urinary incontinence with 19 Gy/1, and none with 27 Gy/2 (6% vs 0%, p=0.0318). G 2-3 urinary tract obstruction was only observed in 4 patients, all of whom were treated with 19 Gy/1. No change in the median EPIC scores at 4 years (follow-up - baseline score) was observed with 27 Gy/2 for urinary, bowel or hormonal domains, but a decline in sexual domain by 16 points. In the single fraction arm, there was no change in the bowel or hormonal domains too, but a drop in sexual domain by 9 points, comparable to 27 Gy/2 (p=0.53). There was a significantly greater drop in urinary domain, function, and bother with 19 Gy/1 (-3.5 vs 0.0, p=0.003; -5.0 vs 0.0, p=0.004; and -3.57 vs 0.0, p=0.006, respectively). Urinary QOL was slightly worse with 19 Gy/1 compared to 27 Gy/2, with greater clinically significant decrement (defined as a decrease in EPIC score >0.5 SD) in urinary domain (46.15% vs 16.67%, p=0.007), function (52.5% vs 15.38%, p=0.0008) and bother (43.59% vs 16.67%, p=0.0136). Treatment with 19 Gy/1 (OR 4.286, p=0.0082) and higher PTV V100 (OR 1.6, p=0.02) were the only factors predictive of clinically significant decrement in urinary QOL. There was no difference in clinically significant decrement between arms in other QOL domains (bowel, sexual, or hormonal). Both single 19 Gy and 13.5 Gy x 2 are well tolerated with low toxicity and good HRQOL at 4 years. Single fraction 19 Gy is associated with higher rates of G-2 urinary toxicity, worse urinary function and bother, and greater decline in urinary QOL at 4 years. Treatment with 19 Gy/1 and having higher PTV V100 are predictive of decrement in urinary QOL.

Forward and inverse-planned intensity-modulated radiotherapy (IMRT) in the CHHiP trial: A comparison of dosimetry and normal tissue toxicity.

37 Background: CHHiP (CRUK/06/016) is a multicentre randomised controlled trial investigating the use of hypofractionated radiotherapy dose schedules for treatment of localised prostate cancer. RT treatment employs a complex target volume treated with either a multi-segment “forward” plan or inverse-planned intensity-modulated radiotherapy (IMRT). This study compares dose-volume histogram (DVH) and toxicity data for rectum and bladder for the two planning techniques. Methods: Three hundred thirty seven patients (230 forward-planned [F]; 107 inverse-planned [I]) with prospectively collected 2 year toxicity and DVH data for rectum and bladder dose constraints were included. Patients were paired for comparison by matching on (1) rectum and prostate + seminal vesicle PTV volumes for the rectal dose comparison (53 matched pairs available); and (2) bladder and prostate-alone PTV volumes for bladder dose comparison (61 matched pairs). For the toxicity comparison patients were additionally matched on randomised dose schedule. Results: Forward-planned patients had significantly larger volumes of rectum irradiated to 50 to 70Gy and bladder at 50 to 60Gy. In contrast, inverse-planned patients had significantly larger volumes of bladder irradiated to 74 Gy. Acute bowel toxicity (G2+ toxicity within 18 weeks of start of RT) was significantly worse in forward-planned patients (27/53 [52%] F vs 11/53 [21%] I; Mann-Whitney p=0.0002). There were no significant differences in acute urinary symptoms. Late toxicity was rare in both planning groups with only two patients (0 F; 2 I) reporting RTOG G2+ bowel/bladder effects at 24 months. Considering LENTSOM data, there was a suggestion of less late bowel toxicity in the inverse group (G1+ at 18 months: 16/53 (30%) F vs. 6/53 (11%) I; p=0.008). Patient reported outcomes of bowel habits showed no consistent differences between planning methods, although there was a tendency for worse urinary function scores in the inverse group at 12 months. Conclusions: Both planning techniques were associated with low late toxicity. Significant differences were found between DVHs from forward and inverse plans. There were some associations between DVH differences and normal tissue effects; these resolved by 2 years. Clinical trial information: CRUK/06/016.

Health-related quality of life results in pathologic Stage C prostate cancer from a Southwest Oncology Group trial comparing radical prostatectomy alone with radical prostatectomy plus radiation therapy: Moinpour CM, Hayden KA, Unger JM, Thompson IM Jr., Redman MW, Canby-Hagino ED, Higgins BA, Sullivan JW, Lemmon D, Breslin S, Crawford ED, Southwest Oncology Group, Southwest Oncology Group Statistical Center, Fred Hutchinson

To compare short- and long-term effects of adjuvant treatment vs. observation after surgery on health-related quality of life (HRQL) of prostate cancer patients. The Southwest Oncology Group (SWOG) intergroup trial compared radical prostatectomy (RP) plus observation vs. RP plus adjuvant radiation therapy (RT). Two-hundred seventeen of 425 therapeutic trial patients were eligible and registered to the HRQL study. Patients completed the SWOG Quality of Life Questionnaire (emotional, physical, social, and role function; general symptom status; treatment/disease-specific symptoms; and global HRQL [GHRQL]) at baseline, 6 weeks, 6 months, and annually for 5 years. Prespecified outcomes were 3 genitourinary symptoms (bowel function tenderness, frequent urination, and erectile dysfunction [ED]) and measures of physical and emotional function. Adjustments were made for the baseline score. Patients receiving adjuvant RT reported worse bowel function (through approximately 2 years) and worse urinary function. There were no statistically significant differences for ED. GHRQL was initially worse for the RP+RT arm but improved over time and was better at the end of the period than the GHRQL reported for RP alone (treatment arm × time interaction, P = 0.0004). Symptom distress was significantly worse for the RP+RT arm compared with the RP alone arm, but the treatment arms did not differ with respect to other general measures of HRQL. The addition of RT to surgery resulted in more frequent urination, as well as early report of more bowel dysfunction, although bowel function differences disappeared over the 5-year period. The addition of RT did not negatively impact ED.

Health-Related Quality of Life Results in Pathologic Stage C Prostate Cancer From a Southwest Oncology Group Trial Comparing Radical Prostatectomy Alone With Radical Prostatectomy Plus Radiation Therapy

To compare short- and long-term effects of adjuvant treatment versus observation after surgery on health-related quality of life (HRQL) of prostate cancer patients. The Southwest Oncology Group (SWOG) intergroup trial compared radical prostatectomy (RP) plus observation versus RP plus adjuvant radiation therapy (RT). Two-hundred seventeen of 425 therapeutic trial patients were eligible and registered to the HRQL study. Patients completed the SWOG Quality of Life Questionnaire (emotional, physical, social, and role function; general symptom status; treatment/disease-specific symptoms; and global HRQL [GHRQL]) at baseline, 6 weeks, 6 months, and annually for 5 years. Prespecified outcomes were three genitourinary symptoms (bowel function tenderness, frequent urination, and erectile dysfunction [ED]) and measures of physical and emotional function. Adjustments were made for the baseline score. Patients receiving adjuvant RT reported worse bowel function (through approximately 2 years) and worse urinary function. There were no statistically significant differences for ED. GHRQL was initially worse for the RP+RT arm but improved over time and was better at the end of the period than the GHRQL reported for RP alone (treatment arm x time interaction, P = .0004). Symptom distress was significantly worse for the RP+RT arm compared with the RP alone arm, but the treatment arms did not differ with respect to other general measures of HRQL. The addition of RT to surgery resulted in more frequent urination, as well as early report of more bowel dysfunction, although bowel function differences disappeared over the 5-year period. The addition of RT did not negatively impact ED.

Psychosocial variables affect the quality of life of men diagnosed with chronic prostatitis/chronic pelvic pain syndrome

To examine interactions between demographic, pain, urinary, psychological and environmental predictors of quality of life (QOL) in men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). In all, 253 men previously enrolled in the National Institutes of Health Chronic Prostatitis Cohort study in North American tertiary-care clinical centres (six in the USA and one in Canada) self-reported with validated instruments, including the QOL subscales of the Short Form-12 (physical, SF12-PCS; and mental, SF12-MCS), demographics, urinary symptoms, depression, current pain, pain coping, 'catastrophizing' (catastrophic thinking about pain), pain control, social support and solicitous responses from a partner. Data were collected through a one-time survey. Covariates determined to be significant were entered into a multivariable regression model predicting SF12-PCS and SF12-MCS. Adjusting for covariates, regression models showed that poorer SF12-PCS scores were predicted by worse urinary function (P < 0.001) and increased use of pain-contingent resting as a coping strategy (P = 0.026). Further, poorer SF12-MCS scores were predicted by greater pain catastrophizing (P = 0.002) and lower perceptions of social support (P< 0.001). In separate follow-up analyses, helplessness was the significant catastrophizing subscale (P < 0.001), while support from family and friends were the significant social support subscales (P = 0.002 and <0.001). These data suggest that specific coping and environmental factors (i.e. catastrophizing, pain-contingent resting, social support) are significant in understanding how patients with CP/CPPS adjust. These data can be used to develop specific cognitive-behavioural programmes for men with CP/CPPS who are refractory to standard medical therapy.

Multicenter, randomized, phase III trial comparing radical retropubic prostatectomy with conventional external beam radiotherapy for localized prostate cancer: An interim report

4607 Background: We report the outcomes of a randomised trial comparing radical retropubic prostatectomy (RP) with conventional external beam radiotherapy (EBRT) in patients with clinically localized prostate cancer. Methods: Between January 1997 and September 2001, 137 patients with clinically localized diagnosed prostate cancer were randomly assigned to RP (n = 70) or EBRT (n = 67). Data collected at follow-up included evidence of clinical disease progression, survival rates and general and disease specific health-related quality of life. All data were measured by physical examination, digital rectal examination, PSA, annual TC and bone scan and questionnaire. Analysis was by intention to treat. Results: After a median follow-up of 67 months (range 24–88) 35 patients (32.8%) had evidence of biochemical disease progression, 22 (31.4%) in RP group and 23 (32.8%) in EBRT group respectively. The median time to biochemical failure was 55.5 months (range 1–86) in RP group and 56 (range 3–88) in EBRT group. A local progression was observed in 11 patients (15.79%) of RP group and 12 (17.9%) of EBRT group. The median time to local progression was 65 months (range 6–86) in RP group and 64 (range 6–88) in EBRT group. Distant metastases were observed in 4 patients (5.7%) in RP group and 6 (8.9%) in EBRT group. The median time to distant failure was 67 months (range 12–86) in RP group and 66 (range 12–88) in EBRT group. Death due to prostate cancer occurred in 3/70 of patients assigned to RP (4.3%) and in 1/67 of those assigned to EBRT (1.5%). A significant decrease in general HRQOL was evident only in the first month after RP (p &lt; 0.001). At 2 years, patients undergoing RP report significantly worse urinary function (p &lt; 0.001), but better bowel function than those treated with EBRT (p &lt; 0.001). Sexual dysfunction was more prevalent in the RP than in the EBRT group (70.2% versus 61.2%). Conclusions: This interim analysis indicates that there was no significant difference between RP and EBRT in terms of clinical disease progression and survival rates in patients with clinically localized prostate cancer. However, additional larger sample size accrual and long-term follow-up data are warranted to confirm these results. No significant financial relationships to disclose.

Health-related quality of life and treatment outcomes for men with prostate cancer treated by combined external-beam radiotherapy and hormone therapy

Health-related quality of life (HR-QOL) is important when considering the treatment options for prostate cancer. From 1992 to 1998, 57 patients were treated by radiotherapy plus hormone therapy (median age, 79 years; median prostate-specific antigen concentration, 15.0 ng/ml; median radiotherapy dosage, 60 Gy). General HR-QOL was measured by the European Organization for Research and Treatment of Cancer Prostate Cancer QOL Questionnaire, and a newly developed disease-specific QOL survey was used to assess urinary and bowel functions. QOL was also measured in a control group of patients admitted for prostate biopsy. The general HR-QOL scores in the radiation group ranged from 70.0 to 91.3, with sexual problems showing the lowest (i.e., worst) score (38.5). Compared with the control group, the scores in the radiation group were worse for physical function and sexual problems. For disease-specific QOL, the radiation group had worse urinary function than controls, but were more satisfied with their urinary function. There was no difference between the radiation group and controls in satisfaction with bowel function. When the control group was subdivided at into two groups: age 75 years or less, and age over 75 years, the QOL score in the radiation group was the same as that in the subgroup aged over 75 years. In subgroups of the radiation patients, according to survey period, there was no difference between the first and last surveys in longitudinal HR-QOL evaluations. The 5- and 10-year overall survival rates were 67.6% and 41.6%, respectively, and the 5- and 10-year cause-specific survival rates were 97.9% and 94.7%. The combination of radiotherapy and hormone therapy has a good outcome and patients do not experience poor HR-QOL, except for sexual problems. Moreover, the disease-specific QOL is good, especially for urinary bother.

前立腺癌患者に対する手術および放射線治療後のQOLの評価

We compared general and disease specific health related quality of life (QOL) after surgery and radiotherapy for prostate cancer. We performed a retrospective survey of patients treated between 1992 and 2001. General and disease specific health related QOL were assessed by the SF-36 and the University of California-Los Angels Prostate Cancer Index (UCLA PCI). We mailed questionnaires of QOL survey and obtained from 143 and 73 men who treated surgery and radiotherapy. The median ages of surgery and radiation group were 70.9 and 79.2 years old, and the median periods after treatment were 2.7 and 2.0 years, respectively. Physical function, role physical, social functioning and mental health were higher score in surgery group than radiation group, however, general health perceptions was higher in radiation group among SF-36. Surgery group had worse urinary function and better sexual function compared with radiation group. Multi-variable analysis showed that scores of social functioning, mental health and sexual function were most influenced by each modality, the scores of physical function, role physical, urinary function and sexual bother were most influenced by age, and the score of general health perceptions and body pain was most influenced by the existence of recurrence. CONSIDERATION: This cross-sectional survey cleared the differences of QOL after surgery and radiotherapy, and the influences of each modality. However, because of difference in background of each group, longitudinal investigation will need to aid patients in the decision making process.

Health related quality of life in Japanese men after radical prostatectomy or radiation therapy for localized prostate cancer.

We performed a retrospective survey of general and disease specific health-related quality of life (HRQOL) after radical prostatectomy (RP) and external beam radiotherapy (XRT) in Japanese men. A total of 186 patients underwent RP and 78 underwent XRT for clinically localized prostate cancer between 2000 and 2002. We measured the general and disease specific HRQOL with the MOS 36-Item Health Survey and the University of California, Los Angeles Prostate Cancer Index, respectively. Each treatment group was further divided into four subgroups according to the time scale. Patients from the RP group were significantly younger than those from the XRT group. The tumor characteristics differed significantly in their distributions among the treatment groups. Patients undergoing XRT had low scores in most of the general measures of HRQOL just after treatment, but after 6 months there were no differences between the treatment groups, except for the physical domains. The RP group was associated with worse urinary function, whereas the XRT group had worse bowel function and bother during the first 6 months after treatment. Thereafter, however, urinary and bowel domain did not differ between the groups. Both groups reported poor sexual function, although the RP group scored lower sexual bother. The patients who underwent RP had significantly worse urinary and better bowel function than those treated with XRT. Both treatment groups had decrements in sexual function throughout the post-treatment period; careful attention should be paid to this side-effect in preoperative counselling, especially in younger patients, regardless of the primary treatments.