PATIENT-REPORTED COMPLICATIONS AND FOLLOW-UP TREATMENT AFTER RADICAL PROSTATECTOMY - THE NATIONAL MEDICARE EXPERIENCE - 1988-1990 (UPDATED JUNE 1993)

To estimate the probabilities of complications and follow-up treatment , a sample of Medicare patients who underwent radical prostatectomy (1 988 through 1990) was surveyed by mail, telephone, and personal interv iew. Respondents reported their current status with respect to contine nce and sexual function as well as post-surgical treatments they had h ad to treat residual or recurrent cancer or surgical complications. Ov er 30 percent reported currently wearing pads or clamps to deal with w etness; over 40 percent said they drip urine when they cough or when t heir bladders are full; 23 percent reported daily wetting of more than a few drops. About 60 percent of patients reported having no full or partial erections since their surgery, and only 11 percent had any ere ctions sufficient for intercourse during the month prior to the survey . Six percent had surgery after the radical prostatectomy to treat inc ontinence; 15 percent had treatments or used devices to help with sexu al function; 20 percent report having had post-surgical treatment for urethral strictures. In addition 16 percent, 22 percent, and 28 percen t reported follow-up treatment for cancer (radiation or androgen depri vation therapy) at two, three, and four years after radical prostatect omy. These estimates of complication and follow-up treatment rates are generally higher, and almost certainly more representative for older men, than estimates previously published. Patients and physicians may want to weigh heavily the complications and need for follow-up treatme nts when considering radical prostatectomy for prostate cancer.