Urologic Morbidity and Its Influence on Global Satisfaction with Treatment Outcome after Radical Prostatectomy for Prostate Cancer

Background : This cross-sectional observational study examined urologic morbidity and its effects on Japanese patients' global satisfaction with their treatment outcome.
Methods : A questionnaire was mailed to 44 men who had undergone radical prostatectomy for prostate cancer at a mean age of 65.5 years and were free from recurrent symptoms at a mean follow-up of 3.3 years. Most (70%) had pathologic stage C or Dl disease and many (86%) had received adjuvant endocrine therapy. After reporting urinary symptoms, the patients estimated their overall urinary, sexual, physical, psychological, and social functioning, and global satisfaction level with their treatment outcome. Regression analysis was performed to detect significant factors in predicting overall urinary conditions or satisfaction.
Results : Daily urinary leakage and forceless urinary stream was noted in 30% and 23% of patients, respectively. Overall urinary conditions were evaluated as good or very good in 61 % of patients, and were most significantly associated with the patient's satisfaction with their force of urinary flow (P< 0.001). Global satisfaction with treatment outcome was estimated as good or very good in 80% of patients, and it was predicted by physical functions (P = 0.01 3) and psychological distress (P = 0.036), and to a lesser extent by urinary conditions (P = 0.1 95).
Conclusion : A forceless urinary stream was the most significant determinant for overall urinary conditions in patients who had a radical prostatectomy. Global satisfaction with treatment outcome was only marginally affected by urinary conditions. PhysicaUunction and psychological distress were major factors affecting the satisfaction level in this population.