Abstract
Objective
To provide insights into the long-term impact of radical retro-pubic prostatectomy
(ORRP) on lower urinary tract symptoms (LUTS) which are age and prostate dependent
and adversely impact quality of life.
Methods
1995 men undergoing ORRP enrolled in a prospective longitudinal outcomes study. The
American Urological Association Symptom Index was self-administered before ORRP and
at predetermined time-points after surgery. A multivariate generalized linear model
was used to evaluate the association of time since ORRP with American Urological Association
symptom score (AUASS). McNemar's test and paired sample t-tests were used to assess whether the proportion of men with clinically significant
LUTS (CSLUTS) defined by an AUASS >7 or mean AUASS differed significantly between
the time-dependent assessments, respectively.
Results
The 15-year mean adjusted AUASS was similar to baseline (7.00 vs 6.85, P = .66). Throughout the 15 years of follow-up, the proportion of men with CSLUTS was
lower than baseline with the exception of the 3 month and 15 year assessments. Among
men with baseline clinically insignificant LUTS (CILUTS), the mean adjusted AUASS
at 15 years was significantly greater than baseline (6.09 vs 3.19, P < .001). Among men with baseline CSLUTS, ORRP led to a significant decrease in mean
adjusted AUASS between baseline and 15 years (13.26 vs 8.67, P < .001).
Conclusion
ORRP favorably affects the long-term natural history of LUTS. The long-term economic
and quality of life benefits of ORRP on LUTS should inform the risks and benefits
of RP for treatment of localized prostate cancer.
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Article info
Publication history
Published online: June 25, 2018
Accepted:
June 10,
2018
Received in revised form:
June 6,
2018
Received:
April 18,
2018
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
