Urinary Continence and Quality of Life in the First Year After Radical Perineal Prostatectomy

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Abstract
Purpose: We attempt to characterize the return of urinary continence and urinary domain related quality of life objectively after radical perineal prostatectomy (RPP). Materials and Methods: A total of 92 RPP candidates were prospectively enrolled in a quality of life (QOL) survey using a validated assessment tool and evaluated before surgery, and then after surgery at 1 month and subsequent 3-month intervals. The time to regain continence based on 3 different definitions and the time to recover baseline urinary domain related QOL was calculated. Results: Median time to regain continence after RPP ranged from 3.0 to 3.3 months depending on the definition of continence. Median time for patients to regain continence depending on age (younger than 55, 55 to 64 and older than 64) and medical comorbidities (none, 1 and 2 or more) varied between 1.4 ± 0.3, 3.0 ± 0.9 and 3.3 ± 0.4 months, respectively (p = 0.028), and 1.4 ± 0.2, 3.3 ± 0.2 and 3.5 ± 2.6 months, respectively (p = 0.009). Twelve months after RPP 84%, 66% and 82% of patients regained individual baseline urinary summary, function and bother scores, respectively. Postoperative radiation (XRT) represented the only independent predictor of the time to recover baseline urinary domain summary scores in a multivariate analysis (p = 0.042) with a median delay in the XRT (10 patients) and nonXRT group (82 patients) of 8.0 and 6.7 months, respectively. Conclusions: Based on self-reported questionnaire data, a majority of patients regain urinary continence and urinary domain related QOL within 12 months after RPP. The time course of recovery from radical prostatectomy represents an important outcome criterion that should be shared with patients considering treatment options.