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Improved lower urinary tract symptoms after robot‐assisted radical prostatectomy: implications for survivorship, treatment selection and patient counselling
Author(s) -
Ahn Thomas,
Roberts Matthew J.,
Strahan Andrew,
Malone Greg,
Paterdis Jason,
Wood Glen,
Heathcote Peter
Publication year - 2019
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.14717
Subject(s) - medicine , international prostate symptom score , lower urinary tract symptoms , prostatectomy , quality of life (healthcare) , prostate cancer , urology , body mass index , prostate , cancer , nursing
Objective To assess changes in lower urinary tract symptoms ( LUTS ) and quality of life (QoL) after robot‐assisted radical prostatectomy ( RARP ). Patients and Methods A prospectively curated database of 1917 consecutive RARP s undertaken over an 8‐year period from January 2009 to January 2017 was assessed. Preoperative information including age, prostate‐specific antigen ( PSA ) level, body mass index ( BMI ), International Prostate Symptom Score ( IPSS ) and QoL score was collected, with IPSS and QoL score compared between baseline (preoperatively) and 12 months post‐surgery. Results Of the 1917 patients who underwent RARP , 1470 with complete data were included in the analysis. Their mean ± sd age, prostate weight and BMI were 62 (±6.7) years, 51 (±17.6) g, and 28 kg/m 2 , respectively. Overall, 57% of patients reported an improved IPSS score, whilst 76% reported an IPSS of ≤7 postoperatively. A total of 41% of patients reported an improved QoL and 90.3% of patients with severe preoperative LUTS ( IPSS 20–35) demonstrated clinically improved LUTS at 1 year post RARP . The post‐ RARP mean IPSS in the present study was lower than those reported in the existing post‐radiotherapy literature, especially in patients with moderate to severe baseline LUTS (IPSS s ≥ 8). Conclusions At 12 months post RARP , most patients reported improved overall LUTS and QoL, with the greatest benefit seen in those patients with a high pre‐ RARP IPSS . This has implications for treatment selection and preoperative counselling in men being offered active treatment for their prostate cancer. Further analyses of specific IPSS domains and longer follow‐up are needed.