Patient-reported quality of life after radical prostatectomy for prostate cancer

Background: Increasingly, quality of life (QOL) assessments are receiving g reater attention in the management of malignancies, including prostate canc er. We evaluated the impact of radical prostatectomy on patient QOL 12 mont hs or longer after surgery. Patients and Methods: We evaluated the impact of radical prostatectomy on Q OL in 60 patients with prostate cancer. The patients comprised two groups: the first group (n = 32) was evaluated 12 months or longer after radical pr ostatectomy; the second group (n = 28) was evaluated while awaiting radical prostatectomy. General health-related QOL was measured with the European O rganization for Research and Treatment of Cancer Prostate Cancer QOL Questi onnaire. Sexual function was assessed with the Sapporo Medical University S exual Function Questionnaire. A newly developed instrument assessing urinar y function was prepared only for the postoperative group. Results: No differences between the two groups were seen in comparisons of general health-related QOL subscales. Men who underwent surgery reported si gnificant deterioration in sexual function (decreased quality of erection, decreased sexual activity and decreased satisfaction with sex life) than th ose awaiting surgery. Of the 32 postoperative patients, 26 (81%) did not us e pads at all, five (16%) used one or fewer pads per day due to occasional spotting and only one patient (3%) used two to four pads per day to deal wi th urine dripping. Twenty-six postoperative patients (81%) stated that, giv en the choice, they would undergo radical prostatectomy again. Conclusions: General health-related QOL does not appear to be compromised f ollowing radical prostatectomy. Patients are willing to accept some morbidi ty for a perceived survival benefit. Although minimal urinary dysfunction w as reported most patients were dissatisfied with postoperative sexual funct ion. In preoperative counselling, greater emphasis should be placed on the risk of postoperative impotence.