Patient-re ported complications and follow-up treatment after radical prostatectomy

TLDR

The study estimates the probabilities of postoperative complications and follow‑up treatments among Medicare patients who underwent radical prostatectomy between 1988 and 1990. A mailed, telephone, and in‑person survey collected self‑reported data on continence, sexual function, and any post‑surgical interventions. More than 30 % of respondents used pads or clamps, over 40 % experienced urinary leakage, 60 % had no erections, 6 % required incontinence surgery, 15 % used sexual‑function aids, 20 % had urethral strictures, and 16–28 % received cancer follow‑up therapy at 2–4 years, indicating complication and treatment rates higher than previously reported.

Abstract

To estimate the probabilities of complications and follow-up treatment, a sample of Medicare patients who underwent radical prostatectomy (1988 through 1990) was surveyed by mail, telephone, and personal interview. Respondents reported their current status with respect to continence and sexual function as well as post-surgical treatments they had had to treat residual or recurrent cancer or surgical complications. Over 30 percent reported currently wearing pads or clamps to deal with wetness; over 40 percent said they drip urine when they cough or when their bladders are full; 23 percent reported daily wetting of more than a few drops. About 60 percent of patients reported having no full or partial erections since their surgery, and only 11 percent had any erections sufficient for intercourse during the month prior to the survey. Six percent had surgery after the radical prostatectomy to treat incontinence; 15 percent had treatments or used devices to help with sexual function; 20 percent report having had post-surgical treatment for urethral strictures. In addition 16 percent, 22 percent, and 28 percent reported follow-up treatment for cancer (radiation or androgen deprivation therapy) at two, three, and four years after radical prostatectomy. These estimates of complication and follow-up treatment rates are generally higher, and almost certainly more representative for older men, than estimates previously published. Patients and physicians may want to weight heavily the complications and need for follow-up treatments when considering radical prostatectomy for prostate cancer.