PTU - Polskie Towarzystwo Urologiczne
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CODE: 7.3 - Quality of life after radical prostatectomy
Article published in Urologia Polska 2006/59/Suplement 1.


Bartłomiej Gliniewicz
Katedra i Klinika Urologii PAM w Szczecinie


Introduction. Radical prostatectomy (RP) belongs to the standards of treatment of patients with organ confined prostate cancer. Beside oncological it is also reconstructive procedure, making possible maintenance of normal urinary and sexual function. There has been observed growing interest of the problem of quality of life recently, also among patients with prostate cancer.
Objectives. To estimate with EORTC questionnaires QLQ-C30 and PR-25 the health-related quality of life (HRQL) in patients with organ confined prostate cancer, treated with retropubic RP, during one year of follow-up, with special regard to the rate of patients achieving one year after surgery at least presurgical functional result.
Materials and methods. HRQL was estimated prospectively in 45 patients before and one year after radical RP. Any neoadjuvant or adjuvant treatment were exclusion criteria for the study. Each time general and prostate cancer - specific HRQL were estimated. Polish versions of EORTC QLQ-C30 and PR-25 questionnaires were used. Preoperative assessment of HRQL allowed us to use the patients as a control group for themselves. Statistical analysis of the results was performed.
Results. General HRQL one year after RP and preoperative, measured with mean values of every domain of EORTC QLQ-C30, do not differ radically. The only clinical and statistical improvement was observed in emotional functioning domain. After 12 months 60-84.4% of patients in functional and general health domains, and 68.8-91.1% of patients in symptomatic domains and questions, achieved or exceeded preoperative status (favorable result). Bowel function and urinary function before and after surgery do not differ statistically. A year after RP, respectively 66.7% and 77.7% of patients achieved favorable functional result in each of both domains (achieved or exceeded preoperative status). Before surgery 25% of patients were not sexually active at all, another 17% very little, according to age and basic disease. Among patients sexually active before surgery 41.2% were still active one year after RP but 71% of them had big problems with quantity and quality of erections. The results in a few domains of PR-25, because of their limited reliability, should be estimated only approximately.
Conclusions. 1. Preoperatively reduced urinary function control and sexual activity in patients qualified to RP are essential factors in assessment of health related quality of life after surgery. 2. Radical prostatectomy does not decrease general health related quality of life considerably. 3. Prostate cancer radical surgery makes it possible for most of patients to achieve 12 months after radical prostatectomy preoperative urinary and bowel function control. 4. Preoperatively reduced sexual functioning even decreases after surgery as a iatrogenic result of radical prostatectomy.