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Quality of life issues after RP

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Posted 4/23/2011 12:45 AM (GMT 0)
Posted on the New Prostate Cancer Info LInk

A prospective study of QOL after surgery by Treiver et al

  • The authors were careful to define their quality of life endpoints for certain key criteria.
    • Potency was defined as the ability to have an “erection sufficient for intercourse upon most attempts with or without a phosphodiesterase type 5 inhibitor.”
    • Continence was defined as “wearing no pads.”
    • Return to baseline quality of life was defined as the achievement of 90 percent of both baseline physical and baseline mental quality of life as experienced pre-surgery.

    So given these important factors, here are the key findings of the study:

    • At 1-year of follow-up
      • 75 percent of patients had returned to baseline physical health.
      • 73 percent of patients had returned to baseline mental health.
      • 75 percent of patients were continent.
      • 26 percent of patients were potent.
    • Mental health recovered more slowly than physical health.
    • Preoperative PSA levels < 20 ng/ml, nerve-sparing technique, no intraoperative or postoperative complications, no adjuvant treatment, and attendance at a postoperative rehabilitation program were all significant factors that positively influenced outcomes in regard to post-surgical health-related quality of life, potency, and continence
    Posted 4/23/2011 1:32 AM (GMT 0)
    I am shocked that the potency rate was only 26 percent.

    But that figure isn't detailed enough since it lumps all age groups into the one group and doesn't specify what degree of potency the men had before the operation.

    The big problem I see is that a doctor pitching a non-surgical treatment (or AS) can tell a just-diagnosed fit and (otherwise) healthy 50 year old with excellent erection capabilities that there is a 74% chance he will have potency problems---and that just isn't true because the study lumped together 50 year olds with 68 year olds and also appears to have lumped together guys with pre-surgury preexisting ED with guys who can perform like they are 18 years old.

    Dan
    Posted 4/23/2011 1:43 AM (GMT 0)
    Doesn't much matter to me what they lump together for statistics. When, at 18 months post-op, you need pads and have total ED even with the meds, you sort of toss all that in the crapper.

    I would rather be in that 80+ group while writing this post.

    Posted 4/23/2011 2:13 AM (GMT 0)
    Hi April6th

    Actually using the criteria for potency .. getting an erection with pill help or without pill help levels the playing field so to speak.  There is no doubt that a younger man (40s-50s) with no prior ED has the edge, as he should.  I am sure statistics will bear that out.  It appears then that the 26% rate is accurate.  

    I am older, but never had an erectile failure before surgery.  Post surgery I am batting 000% with or without pills. However my surgeon lists me as a success because I get 100% success with injections. Using those figures I am part of the 74% failures.  The problem is getting everyone to use the same definition.

    Posted 4/23/2011 2:22 AM (GMT 0)
    Always the trouble with stats like these, the devil is in the details.

    Physical:   50%  (at best, despite 6 1/2 months physical therapy)

    Mental:     How does one quantify that?  I was nuts before and after, lol

    Incontinence:    Prior to urostomy - 100% continent

                             With urostomy device - 100% continent

                             Without urostomy device - 100% incontinent

    ED:   100% ok - before surgery, post surgery, post SRT, all natural

    Post Edited (Purgatory) : 4/22/2011 8:45:06 PM (GMT-6)

    Posted 4/23/2011 2:28 AM (GMT 0)
    I'm in the 75% for physical, mental and continence, however, without the nerve bundles I have 100% ED but trimix does the trick.
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