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The benefits of radical prostatectomy beyond cancer control in symptomatic men with prostate cancer
Author(s) -
Kumar V.,
Toussi H.,
Marr C.,
Hough C.,
Javle P.
Publication year - 2004
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/j.1464-410x.2003.04658.x
Subject(s) - medicine , prostatectomy , prostate cancer , lower urinary tract symptoms , quality of life (healthcare) , radical retropubic prostatectomy , urology , international prostate symptom score , urinary continence , brachytherapy , prostate , radiation therapy , cancer , surgery , nursing
OBJECTIVE To evaluate lower urinary tract symptoms (LUTS) and the symptom‐associated quality of life (QoL) after radical prostatectomy. PATIENTS AND METHODS We carried out a prospective study (January 1999 to March 2001) of 50 consecutive men initially assessed in the nurse‐led prostate assessment clinic for their LUTS and subsequently diagnosed to have localized prostate cancer. They had a radical retropubic prostatectomy and were assessed before, 3 and 6 months after surgery with a self‐administered International Prostate Symptom Score (IPSS) and QoL questionnaires, and measurements of urinary flow rate and postvoid residual urinary (PVR) volumes. Finally, each patient completed a self‐administered continence questionnaire at 6 weeks, 3 and 6 months after surgery. RESULTS In men with moderate to severe LUTS before surgery there were significant improvements in total IPSS, symptom‐associated QoL, mean peak flow rate and PVR ( P < 0.05). However, in eight men with mild LUTS, although there was a 33% improvement in the total symptom score, it was not statistically significant. Thirty‐eight patients reported complete continence, nine had infrequent stress leaks only on heavy physical activity, and the remaining three used < 2 pads/day for protection before heavy physical activity at 3 months after surgery. CONCLUSIONS Radical prostatectomy provides major benefits to men with LUTS besides cancer control. These data are important in counselling patients about the treatment options, especially in view of the current enthusiasm for brachytherapy and conformal radiotherapy, which may worsen LUTS.