Patient-reported urinary continence and sexual function after anatomic radical prostatectomy

Objectives. After radical prostatectomy, the rates for recovery of urinary continence and sexual function reported by experienced surgeons are much hi gher than the patient-reported outcomes from other centers. It is uncertain whether this represents differences in surgical technique or in the collec tion of data. This study was performed to determine patient-reported rates of continence and potency after radical prostatectomy performed by an exper ienced surgeon at a high-volume referral center for the treatment of locali zed prostate cancer. Methods. Sixty-four men with localized prostate cancer who were potent preo peratively and who had sexual partners underwent anatomic radical prostatec tomy between March 1997 and January 1998. A validated disease-targeted qual ity-of-life survey that assesses function and bother in two organ systems ( urinary and sexual) was administered preoperatively and at 3, 6, 12, and 18 months postoperatively. Results. Urinary continence, which was defined as wearing no pads, graduall y improved during the first: 12 months after surgery, and at 12 and 18 mont hs, 93% of the patients were dry. Throughout the study, 93% to 98% of the p atients characterized their urinary bother as none or small. Potency, defin ed as the ability to have unassisted intercourse with or without the use of sildenafil, improved gradually, and by 18 months, 86% of patients were pot ent and 84% considered sexual bother as none or small. Although one third o f patients at 18 months were using sildenafil intermittently, only 2 patien ts were not able to have intercourse without its use. Conclusions. Patient-reported rates of continence and potency after radical prostatectomy performed by an experienced surgeon are high. (C) 2000, Else vier Science Inc.