Multicenter patient self-reporting questionnaire on impotence, incontinence and stricture after radical prostatectomy

Purpose: We determined the incidence of patient self-reported post-prostate ctomy incontinence, impotence, bladder neck contracture and/or urethral str icture, sexual function satisfaction, quality of life and willingness to un dergo treatment again in a large multicenter group of men who underwent rad ical prostatectomy. We also determined whether the morbidities of sexual fu nction satisfaction, quality of life and bladder neck contracture and/or ur ethral stricture are predictable from demographic and postoperative prostat e cancer factors. Materials and Methods: A self-reporting questionnaire was completed and ret urned by 1,069 of 1,396 eligible patients (77%) who underwent radical prost atectomy between 1962 and 1997. Of the respondents 868 (85.7%) underwent su rgery after 1990 and in all prostatectomy had been done a minimum of 6 mont hs previously. Questionnaire results were independently analyzed by a third party for morbidity tabulation and the association of patient reported sat isfaction. Results: The patient self-reported incidence of any degree of post-prostate ctomy incontinence, impotence and bladder neck contracture or urethral stri cture was 65.6%, 88.4% and 20.5%, respectively, The incidence of incontinen ce requiring protection was 33% and only 2.8% of respondents had persistent bladder neck contracture or urethral stricture. Although incontinence and impotence significantly affected self-reported sexual function satisfaction , quality of life and willingness to undergo treatment again (p = 0.001), 7 7.5% of patients would elect surgery again. This finding remained true even after adjusting for demographic variables, and the time between surgery an d the survey by multiple logistic regression. Conclusions: Although radical prostatectomy morbidity is common and affects self-reported overall quality of life, most patients would elect the same treatment again. Impotence and post-prostatectomy incontinence were signifi cantly associated with sexual function satisfaction, quality of life and wi llingness to undergo treatment again. Bladder neck contracture and/or ureth ral stricture was associated with willingness to undergo treatment again af ter adjusting for demographic variables and time from surgery to the survey .