1. ¹Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
2. ²Department of Health Services, School of Public Health, University of California, Los Angeles, CA, USA
3. ³Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, CA, USA
4. ⁴Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA
5. ⁵Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Japan
6. ⁶Department of Urology, Kurashiki Central Hospital, Okayama, Japan
7. ⁷Department of Urology, Kitasato University School of Medicine, Kanakawa, Japan

Correspondence: Dr MS Litwin, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Box 951738, Los Angeles, CA 90095-1738, USA. E-mail: mlitwin@mednet.ucla.edu

Received 22 January 2008; Revised 10 March 2008; Accepted 10 March 2008; Published online 8 April 2008.

Abstract

We assessed the impact of bother with urinary and bowel dysfunction on social activities among men in Japan and the United States following primary therapy for localized prostate cancer. In paired longitudinal outcomes studies, we measured general and disease-specific health-related quality of life in 400 Japanese and 427 American men who underwent radical prostatectomy or brachytherapy for localized prostate cancer. Outcomes included the social function domain of the Medical Outcomes Study Short Form-36 and the University of California, Los Angeles Prostate Cancer Index, all of which are scored 0–100. Participants completed the questionnaires before and 1, 12 and 24 months after treatment. Among men who reported any urinary bother, Japanese men had slightly better urinary function than American men (84 vs 77, P<0.01). Before brachytherapy, urinary bother was weakly correlated with social function in both the countries; after brachytherapy, urinary bother was strongly correlated with social function in American but not Japanese men. After brachytherapy, bowel dysfunction had a stronger correlation with social function in American than Japanese men (P<0.05). The bother associated with urinary and bowel dysfunction after surgery or brachytherapy for prostate cancer has a greater impact on social function in American men than in Japanese men.