The Impact of Prostate Size on Urinary Quality of Life Indexes Following Laparoscopic Radical Prostatectomy
- 31 May 2008
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Urology
- Vol. 179 (5), 1818-1822
- https://doi.org/10.1016/j.juro.2008.01.050
Abstract
We assessed the effects of prostate size on long-term health related quality of life and functional outcomes after laparoscopic radical prostatectomy. A total of 729 consecutive patients who underwent laparoscopic radical prostatectomy for localized prostate cancer were stratified by pathological prostate gland weight, including group 1--less than 35 gm, group 2--35 to 70 gm and group 3--greater than 70 gm. Urinary health related quality of life was assessed preoperatively and at regular intervals following laparoscopic radical prostatectomy using the validated Expanded Prostate Cancer Index Composite questionnaire. A total of 613 evaluable patients were studied with a mean age of 57.7 years, a preoperative prostate specific antigen of 6.0 ng/ml, a median preoperative and postoperative Gleason score of 6, and a mean pathological gland weight of 51.3 gm (range 13.4 to 145.7). Patients with the largest glands had significantly worse baseline urinary function, as demonstrated by Expanded Prostate Cancer Index Composite urinary domain summary (p <0.001) and subscale scores, including scores for urinary bother (p <0.001), urinary irritative/obstructive (p = 0.001) and urinary incontinence (p = 0.03). Patients in group 3 also had significantly older age, a higher body mass index, longer operative time and more blood loss (each p <0.05). Despite preoperative differences and possible confounders all groups approached similar urinary health related quality of life outcomes at all time points postoperatively. At 12 months patients with the largest glands had improved Expanded Prostate Cancer Index Composite urinary irritative/obstructive and urinary bother subscale scores compared to their baseline scores (p <0.05). In laparoscopic radical prostatectomy despite preoperative differences increasing prostatic size is not associated with delayed or worse postoperative urinary health related quality of life. Furthermore, in patients with large glands an improvement in urinary irritative/obstructive and bother symptoms from baseline may be seen 12 months postoperatively.Keywords
This publication has 20 references indexed in Scilit:
- Recovery of Urinary Continence Following Radical Prostatectomy: The Impact of Prostate Volume—Analysis of Data From the CaPSURE™ DatabaseJournal of Urology, 2007
- Impact of Prostate Size in Robot-Assisted Radical ProstatectomyJournal of Endourology, 2007
- Age Stratified Functional Outcomes After Laparoscopic Radical ProstatectomyJournal of Urology, 2006
- Prospective evaluation of learning curve for laparoscopic radical prostatectomy: Identification of factors improving operative timesUrology, 2005
- The Impact of Prostate Size in Laparoscopic Radical ProstatectomyEuropean Urology, 2005
- IMPACT OF PROSTATE SIZE AND BODY MASS INDEX ON PERIOPERATIVE MORBIDITY AFTER LAPAROSCOPIC RADICAL PROSTATECTOMYJournal of Urology, 2005
- A large prostate at radical retropubic prostatectomy does not adversely affect cancer control, continence or potency ratesBJU International, 2003
- Influence of body weight and prostate volume on intraoperative, perioperative, and postoperative outcomes after radical retropubic prostatectomyUrology, 2003
- Today men with prostate cancer have larger prostatesUrology, 2000
- A prostate gland volume of more than 75 cm3 predicts for a favorable outcome after radical prostatectomy for localized prostate cancerUrology, 1998