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Quality of Life After Open Radical Prostatectomy Compared with Robot-assisted Radical Prostatectomy.

Journal article
Authors Anna Wallerstedt
Tommy Nyberg
Stefan Carlsson
Thordis Thorsteinsdottir
Johan Stranne
Stavros I Tyritzis
Karin Stinesen-Kollberg
Jonas Hugosson
Anders Bjartell
Ulrica Wilderäng
Peter Wiklund
Gunnar Steineck
Eva Haglind
Published in European urology focus
Volume 5
Issue 3
Pages 389-398
ISSN 2405-4569
Publication year 2019
Published at Institute of Clinical Sciences, Department of Surgery
Institute of Clinical Sciences, Department of Oncology
Institute of Clinical Sciences, Department of Urology
Pages 389-398
Language en
Keywords Prostate cancer, Quality of life, Radical prostatectomy, Robot-assisted radical prostatectomy
Subject categories Other Medical Sciences


Surgery for prostate cancer has a large impact on quality of life (QoL).To evaluate predictors for the level of self-assessed QoL at 3 mo, 12 mo, and 24 mo after robot-assisted laparoscopic (RALP) and open radical prostatectomy (ORP).The LAParoscopic Prostatectomy Robot Open study, a prospective, controlled, nonrandomised trial of more than 4000 men who underwent radical prostatectomy at 14 centres. Here we report on QoL issues after RALP and ORP.The primary outcome was self-assessed QoL preoperatively and at 3 mo, 12 mo, and 24 mo postoperatively. A direct validated question of self-assessed QoL on a seven-digit visual scale was used. Differences in QoL were analysed using logistic regression, with adjustment for confounders.QoL did not differ between RALP and ORP postoperatively. Men undergoing ORP had a preoperatively significantly lower level of self-assessed QoL in a multivariable analysis compared with men undergoing RALP (odds ratio: 1.21, 95% confidence interval: 1.02-1.43), that disappeared when adjusted for preoperative preparedness for incontinence, erectile dysfunction, and certainty of being cured (odds ratio: 1.18, 95% confidence interval: 0.99-1.40). Incontinence and erectile dysfunction increased the risk for poor QoL at 3 mo, 12 mo, and 24 mo postoperatively. Biochemical recurrence did not affect QoL. A limitation of the study is the nonrandomised design.QoL at 3 mo, 12 mo, and 24 mo after RALP or ORP did not differ significantly between the two techniques. Poor QoL was associated with postoperative incontinence and erectile dysfunction but not with early cancer relapse, which was related to thoughts of death and waking up at night with worry.We did not find any difference in quality of life at 3 mo, 12 mo, and 24 mo when open and robot-assisted surgery for prostate cancer were compared. Postoperative incontinence and erectile dysfunction were associated with poor quality of life.

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