Elsevier

Urology

Volume 45, Issue 6, June 1995, Pages 1007-1015
Urology

Adult urology
Effect of radical prostatectomy for prostate cancer on patient quality of life: results from a medicare survey*

https://doi.org/10.1016/S0090-4295(99)80122-8Get rights and content
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Abstract

Objectives

To assess patient responses to radical prostatectomy and its effects.

Methods

A national sample was taken of 1072 Medicare patients who underwent radical prostatectomy for prostate cancer (1988 through 1990) by mail, telephone, and personal interviews. The effects of the surgery and its complications on these patients' lives were studied through: (1) patient ratings of the extent to which sexual and urinary dysfunctions were “problems” in their lives; (2) two general measures of quality of life, the Mental Health Index and the General Health Index; (3) patient reports of how they felt about the results of treatment and whether they would choose surgery again.

Results

On average, dripping urine, particularly to the point where subjects were wearing pads, had a more significant effect on patients than loss of sexual function; incontinence had significant adverse effects on the measures of quality of life and selfreported results of surgery. Overall, postsurgical patients scored comparatively high on the quality of life measures (similar to a cohort of patients with benigh prostatic hyperplasia who had undergone transurethral resection of the prostate), reported feeling positive about the results (81%), and would choose surgical treatment again (89%). Nonetheless, there was variability in patient response to the effects of surgery.

Conclusions

The results demonstrate the ability of many Medicare patients to adapt to adverse outcomes, such as loss of sexual function and incontinence. They also provide evidence of the variability of individual patients' responses to surgical results and reinforce the importance of individualized decision making for patients facing a decision about radical prostatectomy for prostate cancer.

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*

This research was supported by grants HS 06336 and 08397 from the Agency for Health Care Policy and Research.