Early postoperative urinary and sexual function predicts functional recovery 1 year after prostatectomy. J Urol 2013 Oct;190(4):1233-8
Date
04/24/2013Pubmed ID
23608677DOI
10.1016/j.juro.2013.04.045Scopus ID
2-s2.0-84883806223 (requires institutional sign-in at Scopus site) 5 CitationsAbstract
PURPOSE: Successful treatment of locally confined prostate cancer is defined by postoperative cancer control, continence and potency. The Expanded Prostate Cancer Index Composite (EPIC) is a validated instrument developed specifically for prostate cancer survivors. The EPIC-Sexual Inventory (EPIC-S) and EPIC-Urinary Inventory (EPIC-UIN) assess sexual and urinary function, respectively. We evaluated the usefulness of urinary and sexual function measured by EPIC at baseline and 3-month followup after prostatectomy to predict functional outcomes 1 year postoperatively.
MATERIALS AND METHODS: We retrospectively reviewed a prospectively maintained, institutional review board approved database for patients treated with prostatectomy from 2000 to 2009. EPIC scores were acquired preoperatively, and at 3 and 12-month followups. We calculated the likelihood of sexual and urinary recovery at 12 months based on 3-month EPIC-UIN and EPIC-S scores.
RESULTS: Patients were treated with open (226) or robotic (235) surgery. The 437 patients with complete EPIC-UIN questionnaires had worsened (2.7%), improved (47.8%) or stable (49.4%) urinary function, and the 436 with complete EPIC-S questionnaires had worsened (3.9%), improved (36.9%) or stable (59.2%) sexual function at 12 months compared to 3-month scores. Return to baseline was predicted by 3-month EPIC-UIN scores of 50 or greater (OR 7.76) and EPIC-S scores of 45 or greater (OR 3.64, each p <0.0001). The Pearson correlation coefficient of 3 and 12-month EPIC-UIN and EPIC-S scores was 0.65 and 0.73, respectively.
CONCLUSIONS: Three-month EPIC-UIN and EPIC-S scores were useful for predicting 12-month functional outcomes. Health related quality of life instruments should be applied in the early postoperative period to aid in counseling patients on recovery.
Author List
Ellison JS, He C, Wood DPAuthor
Jonathan Scott Ellison MD Associate Professor in the Urologic Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Humans
Male
Middle Aged
Postoperative Period
Prostatectomy
Prostatic Neoplasms
Recovery of Function
Retrospective Studies
Sexuality
Surveys and Questionnaires
Time Factors
Urination