Health related quality of life outcomes after radical prostatectomy: Attention to study design and the patient-based importance of single-surgeon studies

ObjectiveTo define accurately health related quality of life outcomes in men undergoing radical prostatectomy (RP) by a single surgeon.Materials and MethodsSince September 1999, men undergoing RP were asked to complete the Medical Outcomes Study Short Form-36 (SF-36) and University of California Los Angeles Prostate Cancer Index preoperatively, returning it to a third party data center. Anonymous surveys were mailed to each patient at 1 and 2 years.ResultsWe captured 90% and 82% of men at 1 and 2 years, respectively. Mean scores in the SF-36 domains and bowel function/bother were unchanged from preoperative at 1 and 2 years. Urinary function and bother scores were lower at year 1, but stable at year 2. Men wearing ≥1 pad/d scored significantly lower in urinary function and bother than those noted as pad-free. Pad-free rates were 82% at year 1 and 89% at year 2. Sexual function and bother scores were significantly lower at years 1 and 2. In men younger than 60 years with unilateral nerve-sparing surgery, at 2 years, 50% had erections adequate for intercourse.ConclusionsThis single-surgeon outcomes study after RP showed stability in the SF-36 and bowel domains to 2 years. At 2 years, the vast majority of men were pad-free (89%), and the majority of young men after unilateral nerve-sparing surgery had erections adequate for intercourse (50%). Accurate outcomes measurement can assist in comparing treatments and physicians, and in counseling patients on expected outcomes for localized prostate cancer interventions.