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Use of a validated quality of life questionnaire to assess sexual function following laparoscopic radical prostatectomy

Abstract

Wide variations exist in the methods for evaluating potency following radical prostatectomy. We describe our technique of laparoscopic radical prostatectomy (LRP), present our methods for assessing the return of potency following LRP, and discuss the relevant literature. Sexual function was assessed pre- and postoperatively using the Expanded Prostate Cancer Index Composite questionnaire (EPIC). Sexual function subscale scores (SFSS) were reported as a percentage of preoperative baseline sexual function. The EPIC was also used for single-question assessment of successful intercourse. We also reviewed the literature on prospective health-related quality of life results following LRP and open radical retropubic prostatectomy. Only patients reporting preoperative intercourse were analyzed. Of these, 72 and 35% undergoing bilateral and unilateral nerve sparing (NS) reported postoperative intercourse at 12 months (P=0.01). Mean SFSS at 12 months was 61 and 57% of baseline after bilateral and unilateral NS, respectively (P=0.71). Following NS procedures, 74% of patients 58 years of age and 41% of patients >58 years of age reported successful intercourse at 12 months (P=0.015). Mean SFSS was 64 and 52% of baseline function (P=0.249) at 12 months for patients 58 and >58 years of age, respectively. In patients <58 years of age who underwent bilateral NS surgery, 82% reported intercourse at 12 months. In conclusion, return of sexual function following NS LRP in our experience is comparable to reports from centers of excellence in open prostatectomy. Standardizing data collection using validated quality of life instruments can provide both surgeon and patient with a realistic forecast of relative return to normal sexual function following prostatectomy.

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References

  1. Roehl KA, Han M, Ramos CG, Antenor JA, Catalona WJ . Cancer progression and survival rates following anatomical radical retropubic prostatectomy in 3, 478 consecutive patients: long-term results. J Urol 2004; 172: 910–914.

    Article  PubMed  Google Scholar 

  2. Han M, Partin AW, Pound CR, Epstein JI, Walsh PC . Long-term biochemical disease-free and cancer-specific survival following anatomic radical retropubic prostatectomy. The 15-year Johns Hopkins experience. Urol Clin North Am 2001; 28: 555–565.

    Article  CAS  PubMed  Google Scholar 

  3. Catalona WJ, Carvalhal GF, Mager DE, Smith DS . Potency, continence and complication rates in 1,870 consecutive radical retropubic prostatectomies. J Urol 1999; 162: 433–438.

    Article  CAS  PubMed  Google Scholar 

  4. Walsh PC, Marschke P, Ricker D, Burnett AL . Patient-reported urinary continence and sexual function after anatomic radical prostatectomy. Urology 2000; 55: 58–61.

    Article  CAS  PubMed  Google Scholar 

  5. Talcott JA, Rieker P, Propert KJ, Clark JA, Wishnow KI, Loughlin KR et al. Patient-reported impotence and incontinence after nerve-sparing radical prostatectomy. J Natl Cancer Inst 1997; 89: 1117–1123.

    Article  CAS  PubMed  Google Scholar 

  6. Potosky AL, Davis WW, Hoffman RM, Stanford JL, Stephenson RA, Penson DF et al. Five-year outcomes after prostatectomy or radiotherapy for prostate cancer: the prostate cancer outcomes study. J Natl Cancer Inst 2004; 96: 1358–1367.

    Article  PubMed  Google Scholar 

  7. McCammon KA, Kolm P, Main B, Schellhammer PF . Comparative quality-of-life analysis after radical prostatectomy or external beam radiation for localized prostate cancer. Urology 1999; 54: 509–516.

    Article  CAS  PubMed  Google Scholar 

  8. Kundu SD, Roehl KA, Eggener SE, Antenor JA, Han M, Catalona WJ . Potency, continence and complications in 3,477 consecutive radical retropubic prostatectomies. J Urol 2004; 172: 2227–2231.

    Article  PubMed  Google Scholar 

  9. Stanford JL, Feng Z, Hamilton AS, Gilliland FD, Stephenson RA, Eley JW et al. Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: the Prostate Cancer Outcomes Study. JAMA 2000; 283: 354–360.

    Article  CAS  PubMed  Google Scholar 

  10. Madalinska JB, Essink-Bot ML, de Koning HJ, Kirkels WJ, van der Maas PJ, Schroder FH . Health-related quality-of-life effects of radical prostatectomy and primary radiotherapy for screen-detected or clinically diagnosed localized prostate cancer. J Clin Oncol 2001; 19: 1619–1628.

    Article  CAS  PubMed  Google Scholar 

  11. Bhayani SB, Pavlovich CP, Hsu TS, Sullivan W, Su LM . Prospective comparison of short-term convalescence: laparoscopic radical prostatectomy versus open radical retropubic prostatectomy. Urology 2003; 61: 612–616.

    Article  PubMed  Google Scholar 

  12. Link RE, Su LM, Sullivan W, Bhayani SB, Pavlovich CP . Health related quality of life before and after laparoscopic radical prostatectomy. J Urol 2005; 173: 175–179; discussion 179.

    Article  PubMed  Google Scholar 

  13. Rassweiler J, Schulze M, Teber D, Seemann O, Frede T . Laparoscopic radical prostatectomy: functional and oncological outcomes. Curr Opin Urol 2004; 14: 75–82.

    Article  PubMed  Google Scholar 

  14. Gralnek D, Wessells H, Cui H, Dalkin BL . Differences in sexual function and quality of life after nerve sparing and nonnerve sparing radical retropubic prostatectomy. J Urol 2000; 163: 1166–1169; discussion 1169–1170.

    Article  CAS  PubMed  Google Scholar 

  15. Hollenbeck BK, Dunn RL, Wei JT, Montie JE, Sanda MG . Determinants of long-term sexual health outcome after radical prostatectomy measured by a validated instrument. J Urol 2003; 169: 1453–1457.

    Article  PubMed  Google Scholar 

  16. Litwin MS, Melmed GY, Nakazon T . Life after radical prostatectomy: a longitudinal study. J Urol 2001; 166: 587–592.

    Article  CAS  PubMed  Google Scholar 

  17. Hu JC, Elkin EP, Pasta DJ, Lubeck DP, Kattan MW, Carroll PR et al. Predicting quality of life after radical prostatectomy: results from CaPSURE. J Urol 2004; 171: 703–707; discussion 707–708.

    Article  PubMed  Google Scholar 

  18. Wei JT, Dunn RL, Litwin MS, Sandler HM, Sanda MG . Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer. Urology 2000; 56: 899–905.

    Article  CAS  PubMed  Google Scholar 

  19. Su LM, Link RE, Bhayani SB, Sullivan W, Pavlovich CP . Nerve-sparing laparoscopic radical prostatectomy: replicating the open surgical technique. Urology 2004; 64: 123–127.

    Article  PubMed  Google Scholar 

  20. Guillonneau B, Vallancien G . Laparoscopic radical prostatectomy: initial experience and preliminary assessment after 65 operations. Prostate 1999; 39: 71–75.

    Article  CAS  PubMed  Google Scholar 

  21. Ong AM, Su LM, Varkarakis I, Inagaki T, Link RE, Bhayani SB et al. Nerve sparing radical prostatectomy: effects of hemostatic energy sources on the recovery of cavernous nerve function in a canine model. J Urol 2004; 172: 1318–1322.

    Article  PubMed  Google Scholar 

  22. Eastham JA, Kattan MW, Riedel E, Begg CB, Wheeler TM, Gerigk C et al. Variations among individual surgeons in the rate of positive surgical margins in radical prostatectomy specimens. J Urol 2003; 170: 2292–2295.

    Article  PubMed  Google Scholar 

  23. Hu JC, Gold KF, Pashos CL, Mehta SS, Litwin MS . Role of surgeon volume in radical prostatectomy outcomes. J Clin Oncol 2003; 21: 401–405.

    Article  PubMed  Google Scholar 

  24. Litwin MS, Lubeck DP, Henning JM, Carroll PR . Differences in urologist and patient assessments of health related quality of life in men with prostate cancer: results of the CaPSURE database. J Urol 1998; 159: 1988–1992.

    Article  CAS  PubMed  Google Scholar 

  25. Talcott JA, Rieker P, Clark JA, Propert KJ, Weeks JC, Beard CJ et al. Patient-reported symptoms after primary therapy for early prostate cancer: results of a prospective cohort study. J Clin Oncol 1998; 16: 275–283.

    Article  CAS  PubMed  Google Scholar 

  26. Guillonneau B, Vallancien G . Laparoscopic radical prostatectomy: the Montsouris experience. J Urol 2000; 163: 418–422.

    Article  CAS  PubMed  Google Scholar 

  27. Turk I, Deger S, Winkelmann B, Schonberger B, Loening SA . Laparoscopic radical prostatectomy. Technical aspects and experience with 125 cases. Eur Urol 2001; 40: 46–52; discussion 53.

    Article  CAS  PubMed  Google Scholar 

  28. Rassweiler J, Sentker L, Seemann O, Hatzinger M, Rumpelt HJ . Laparoscopic radical prostatectomy with the Heilbronn technique: an analysis of the first 180 cases. J Urol 2001; 166: 2101–2108.

    Article  CAS  PubMed  Google Scholar 

  29. Eden CG, Cahill D, Vass JA, Adams TH, Dauleh MI . Laparoscopic radical prostatectomy: the initial UK series. BJU Int 2002; 90: 876–882.

    Article  CAS  PubMed  Google Scholar 

  30. Dahl DM, L'esperance JO, Trainer AF, Jiang Z, Gallagher K, Litwin DE et al. Laparoscopic radical prostatectomy: initial 70 cases at a US university medical center. Urology 2002; 60: 859–863.

    Article  PubMed  Google Scholar 

  31. Rassweiler J, Schulze M, Teber D, Marrero R, Seemann O, Rumpelt J et al. Laparoscopic radical prostatectomy with the Heilbronn technique: oncological results in the first 500 patients. J Urol 2005; 173: 761–764.

    Article  PubMed  Google Scholar 

  32. Guillonneau B, el-Fettouh H, Baumert H, Cathelineau X, Doublet JD, Fromont G et al. Laparoscopic radical prostatectomy: oncological evaluation after 1,000 cases a Montsouris Institute. J Urol 2003; 169: 1261–1266.

    Article  CAS  PubMed  Google Scholar 

  33. Guillonneau B, Cathelineau X, Doublet JD, Baumert H, Vallancien G . Laparoscopic radical prostatectomy: assessment after 550 procedures. Crit Rev Oncol Hematol 2002; 43: 123–133.

    Article  PubMed  Google Scholar 

  34. Katz R, Salomon L, Hoznek A, de la Taille A, Vordos D, Cicco A et al. Patient reported sexual function following laparoscopic radical prostatectomy. J Urol 2002; 168: 2078–2082.

    Article  PubMed  Google Scholar 

  35. Roumeguere T, Bollens R, Vanden Bossche M, Rochet D, Bialek D, Hoffman P et al. Radical prostatectomy: a prospective comparison of oncological and functional results between open and laparoscopic approaches. World J Urol 2003; 20: 360–366.

    PubMed  Google Scholar 

  36. Anastasiadis AG, Salomon L, Katz R, Hoznek A, Chopin D, Abbou CC . Radical retropubic versus laparoscopic prostatectomy: a prospective comparison of functional outcome. Urology 2003; 62: 292–297.

    Article  PubMed  Google Scholar 

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Correspondence to A Wagner.

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Wagner, A., Link, R., Pavlovich, C. et al. Use of a validated quality of life questionnaire to assess sexual function following laparoscopic radical prostatectomy. Int J Impot Res 18, 69–76 (2006). https://doi.org/10.1038/sj.ijir.3901376

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