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Quality of life in young men after radical prostatectomy

Prostate Cancer and Prostatic Diseases volume 11, pages 67–73 (2008)Cite this article

Abstract

Urinary and sexual function and bother are important outcomes following radical prostatectomy (RP). Since urinary and sexual function are age-related, post-operative bother may vary by age. This study explores the disease-specific quality-of-life outcomes in young men compared with older men undergoing RP. Using CaPSURE data, we identified men who underwent RP and completed the UCLA Prostate Cancer Index (PCI) before and 1-year post-RP. Men were stratified by age (<55 years, 55–64, ⩾65). Multivariate regression models were created: a linear model for predictors of PCI scores and a logistic model for predictors of severe declines in PCI domains. Younger men scored significantly better than older men in urinary function (P=0.04), urinary bother (P=0.02) and sexual function (P<0.0001) 1-year post-RP. Severe declines in urinary bother (odds ratio (OR)=1.54, 1.01–2.35) and sexual function (OR=3.20, 1.97–5.19) were more common in men ⩾65 years. Men with relationships had less urinary bother (P=0.03) and were less likely to experience severe worsening of urinary bother (OR=0.32, 0.17–0.60) while having a greater risk of severe worsening of sexual bother (OR=2.74, 1.28–5.89). The use of sexual aids was associated with worse sexual bother (P<0.0001) and greater risk of severe worsening of sexual bother (OR=2.29, 1.54–3.30). Baseline PCI scores were independent predictors in all models. One year after RP, younger men (age<55) have similar, or better, urinary and sexual function and bother. Baseline scores are strongly associated with post-RP scores and severity of declines. Current relationships and use of sexual aids have significant roles in post-RP bother.

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Acknowledgements

The current CaPSURE(tm) Investigators are as follows: Peter R Carroll, MD (University of California, San Francisco, CA); James S Cochran, MD (Urology Clinics of North Texas, Dallas, TX); Christopher J Kane, MD (Veterans Administration Medical Center, San Francisco, CA); Donald P Finnerty, MD (PAPP Clinic, Newnan, GA); Eugene V Kramolowsky, MD (The Virginia Urology Center, Richmond, VA); Robert M Segaul, MD (Urology Associates of West Broward, Sunrise, FL); Paul Sieber, MD (Urological Associates of Lancaster, Lancaster, PA); Stanley A Brosman, MD (Pacific Urology Institute, Santa Monica, CA); Lynn W Conrad, MD (The Conrad Pearson Clinic, Germantown, TN); Ronald A Chee-Awai, MD (Urologic Institute of New Orleans, Marrero, LA); Michael Flanagan, MD (Urology Specialists, PC, Waterbury, CT); Jeffrey K Cohen, MD (Triangle Urology Group, Pittsburgh, PA); Jerrold Sharkey, MD (Urology Health Center, New Port Richey, FL); Thomas W Coleman, MD (Bay Urology Services, Mobile, AL); Elliott C Silbar, MD (Clinic of Urology, SC, Milwaukee, WI); Paul S Ray, DO (John H Stroger Hospital of Cook County, Chicago, IL); David Noyes, MD (Berkshire Urological Associates, PC, Pittsfield, MA); Mohammed Mostafavi, MD (Urology Group of Western NewEngland, Springfield, MA); Louis Keeler, III, MD (Delaware Valley Urology, LLC-Voorhees, Voorhees, NJ); James Gottesman, MD (Seattle Urological, Seattle, WA); Bhupendra M Tolia, MD (Associated Advanced Adult & Pediatric Urology, Bronx, NY); Patrick P Daily, MD (Mississippi Urology, Jackson, MS); Glen Wells, MD (Alabama Urology, Birmingham, AL); Richard J Kahnoski, MD (Michigan Medical, PC Urology, Grand Rapids, MI); Sheldon J Freedman, MD (Las Vegas, NV); Randil Clark, MD (North Idaho Urology, Coeur D'Alene, ID); Daniel W Lin, MD (Veterans Administration Puget Sound HCS, Seattle, WA); Mark Austenfeld, MD (Kansas City Urology Care, Kansas City, MO); Henri P Lanctin, MD (Adult & Pediatric Urology, Sartell, MN); J Brantley Thrasher, MD (University of Kansas, Adult Urology and Urologic Oncology, Kansas City, KS); David W Bowyer, MD (Snake River Urology, Twin Falls, ID). Former CaPSURE investigators are as follows: John Forrest, MD (1995–99, Urologic Specialists of Oklahoma, Tulsa, OK); William Schmeid, MD (1995–99, Metro Urology, Jeffersonville, IN); Glen Brunk, MD (1995–99, Urology of Indiana, Indianapolis, IN); Jay Young, MD (1995–2001, South Orange County Medical Research Center, Laguna Woods, CA); Gary Katz, MD (1996–2000, Medical College of Virginia and Veterans Administration Medical Center, Richmond, VA); Stacy J Childs, MD (1999–2000, Cheyenne Urological, Cheyenne, WY); Kevin Tomera, MD (1999–2001, Alaska Urological Associates, Anchorage, AK); Clayton Hudnall, MD (1995–2002, Urology San Antonio Research, San Antonio, TX); David Penson, MD, MPH (2000–2003, Veterans Administration Puget Sound HCS, Seattle, WA); W Lamar Weems, MD (1996–2005, Mississippi Urology, Jackson, MS); Joseph N Macaluso, Jr, MD (1995–2005, Urologic Institute of New Orleans, Gretna, LA). This work was supported by TAP Pharmaceutical Products Inc.

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Authors and Affiliations

  1. Department of Urology, University of Washington School of Medicine, Seattle, WA, USA

    J L Wright & D W Lin

  2. Department of Urology, University of California, San Francisco, CA, USA

    J E Cowan & P R Carroll

  3. Departments of Urology and Health Services, University of California, Los Angeles, CA, USA

    M S Litwin

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Wright, J., Lin, D., Cowan, J. et al. Quality of life in young men after radical prostatectomy. Prostate Cancer Prostatic Dis 11, 67–73 (2008). https://doi.org/10.1038/sj.pcan.4500980

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