Presentation Authors: Thomas Ahn, Matthew Roberts*, Andrew Strahan, Gregory Malone, Jason Paterdis, Glen Wood, Peter Heathcote, Brisbane, Australia
Introduction: Prostate cancer (CaP) survivorship after prostatectomy is plagued by negative functional outcomes, such as incontinence and erectile dysfunction. Despite being prevalent in this age group, the effects on lower urinary tract symptoms (LUTS) after surgery are minimally described, thus the aim of this study was to assess LUTS and QOL using the International Prostate Severity Score (IPSS) following RALP.
Methods: A prospectively curated database of 1917 consecutive robotic assisted laparoscopic prostatectomies (RALPs) undertaken over an 8-year period from January 2009 to January 2017 was assessed. Pre-operative information including age, prostate specific antigen (PSA), body mass index (BMI), International Prostate Severity Score (IPSS) and quality of life (QoL) scores were compared to IPSS and QOL scores reported at 12 months post-surgery.
Results: Of the 1917 men who underwent RALP, 1470 with complete data were included in the analysis. The mean age, prostate weight and BMI were 62 (+/- 6.7) years, 51 (+/- 17.6) g, and 28 kg/m2, respectively. Overall, 57% of men had an improved IPSS score, with 76% (from 60%) scoring IPSS 7 or less post-operatively. 41% reported an improved QoL. 32% of men reported a worse IPSS or QoL. In a subgroup analysis, 63.7% and 90.3% of patients with pre-surgery moderate LUTS (IPSS 8-19) and severe LUTS (20-35) respectively, demonstrated significantly improved IPSS scores (IPSS change of 5 or more) at 1-year post RALP whilst 81.3% with pre-surgery mild LUTS (IPSS 0-7) remained stable (-5 to 5 IPSS change). Our post-RALP mean IPSS scores were lower (less urinary symptoms) when compared with existing literature post-radiation therapy especially in the baseline moderate and severe IPSS scores (IPSS 8 or more).
Conclusions: At 12-months post-RALP, most men reported improved overall LUTS and QoL, with greater benefit seen in those patients with high pre-RALP IPSS and worse LUTS with low IPSS. Further analyses on specific IPSS domains and longer follow up are needed.