Long-term outcomes in severe lower urinary tract symptoms in men undergoing robotic-assisted radical prostatectomy.
Urology
; 84(4): 826-31, 2014 Oct.
Article
em En
| MEDLINE
| ID: mdl-25102787
ABSTRACT
OBJECTIVE:
To address a major concern driving treatment intervention, we studied incontinence and urinary quality of life (QOL) before and after robotic-assisted radical prostatectomy (RARP). In men with severe lower urinary tract symptoms (LUTS), this is the first observational study analyzing short- and long-term urinary outcomes of RARP. MATERIALS ANDMETHODS:
RARP was performed on 665 patients by 1 surgeon from 2002 to 2007. Men returned preoperative and postoperative self-reported American Urological Association symptom score (AUAss), urinary QOL, and continence (pad usage) questionnaires. Men with preoperative severe LUTS (AUAss ≥ 20; n = 53; 8%) were observed longitudinally for a mean of 4.0 years (range, 1.6-9.4 years) and were compared with men with mild-to-moderate LUTS (AUAss ≤ 19; n = 612; 92%).RESULTS:
In men with severe LUTS, baseline average AUAss and QOL scores were 24.8 and 4.0, respectively. Long-term AUAss improved by 70% (17 points; P < .001); specifically 59% of patients had AUAss drop to <8, 35% of patients to 8-19, and 6% of patients remained at ≥ 20. The mean QOL scores declined from 4.0 to 2.0 (P < .05). Preoperatively, 38 of 52 patients (73%) had a poor QOL score of 4-6 compared with only 18% (P < .001) at long-term follow-up after RARP. Overall pad-free status was 71% vs 89%.CONCLUSION:
In men with severe LUTS, RARP significantly improved urinary symptoms and QOL scores with an overall pad-free status of 71%. Specifically, these men should be counseled that RARP confers a significant short- and long-term benefit with regard to relief of their obstructive and irritative symptoms.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Prostatectomia
/
Qualidade de Vida
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Sintomas do Trato Urinário Inferior
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Procedimentos Cirúrgicos Robóticos
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article