PTU - Polskie Towarzystwo Urologiczne
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CODE: 21.1 - Comparison of perioperative psychological stress in patients treated with radical prostatectomy and suprapubic adenomectomy
Article published in Urologia Polska 2006/59/Suplement 1.


Pawe³ Kalwas, Zbigniew Kwias, Robert Ku¼ma, Witold Malendowicz, Micha³ Hrab
Klinika Urologii AM w Poznaniu


Introduction. Radical prostatectomy and suprapubic adenomectomy are two main open procedures in surgery of prostate. It seems that radical prostatectomy is more stressful operation for patient, because it is connected with more significant blood loss and destruction of tissues than in case of suprapubic adenomectomy. Though, everyday clinical observations suggest that perioperative period is less stressful for patients after radical prostatectomy. There are no articles in literature concerning this problem.
Objectives. The aim of the research is to compare the frame of mind of patients who were treated with radical prostatectomy to patients who underwent suprapubic adenomectomy using well known and appreciated tools measuring intensity of anxiety, depression, negative emotions and aggression in perioperative period.
Materials and methods. 50 male patients who underwent radical prostatectomy and 50 patients treated with suprapubic adenomectomy were recruited. The Mini Mental State Examination scale was used to exclude patients who are not able to understand the questionnaires. Depression was measured with Beck's and Hamilton's scales. HADS-M (Hospital Anxiety Depression Scale) was used to assess anxiety, depression and aggression. Anxiety as state and trait was measured separately using STAI (State-Trait Anxiety Inventory). There was also used a scale assessing social functioning of the patients to check if bigger stress in some patients is connected with worse functioning in common life.
Results. Patients treated with radical prostatectomy go through the perioperative period with more intensive psychological stress. The intensity of emotions during this time changes also in more visible way. There are two critical moments: last days before operation and three days after surgery.
Conclusions. Perioperative stress in patients undergoing radical prostatectomy is bigger and more dynamic. Though in late perioperative period they feel much better. That makes easier the return to normal everyday activities.