Counseling the post-radical prostatectomy patients about functional recovery: High predictiveness of current status Journal Article


Authors: Vickers, A. J.; Kent, M.; Mulhall, J.; Sandhu, J.
Article Title: Counseling the post-radical prostatectomy patients about functional recovery: High predictiveness of current status
Abstract: Objective To develop prediction models to help counsel post-radical prostatectomy patients about functional recovery. Methods The study included 2162 patients undergoing radical prostatectomy at a major cancer center, who reported urinary and erectile function at 1 year or at 2 years and at least 1 prior follow-up at 3, 6, 9, or 12 months. We created logistic regression models predicting function at one or 2 years on the basis of function at 3, 6, 9, and 12 months (2 years only), with the additional predictors of age, stage, grade, prostate-specific antigen levels, nerve-sparing status and baseline functional score. Results No variable other than current functional score had a consistent statistically significant relationship with outcome. The area under the curves for predicting function at 2 years based on current function alone at 3, 6, 9, and 12 months were respectively 0.796, 0.831, 0.882, and 0.885 for erectile function and 0.789, 0.862, 0.869, and 0.876 for urinary function. Patients using 1 pad at 6 months had only a 50% probability of being pad free at 2 years; this dropped to 36% for patients using 2 pads. This suggests that there is an opportunity for early identification and possible referral of patients likely to have long-term urinary dysfunction. Conclusion Assessment of urinary and erectile function in the first postoperative year is strongly predictive of long-term outcome and can guide patient counseling and decisions about rehabilitative treatments. © 2014 Elsevier Inc.
Keywords: adult; controlled study; aged; major clinical study; postoperative period; area under the curve; follow up; prostate specific antigen; clinical assessment; prediction; gleason score; questionnaire; prostatectomy; convalescence; patient counseling; predictive value; international index of erectile function; urinary dysfunction; prognosis; human; male; priority journal; article
Journal Title: Urology
Volume: 84
Issue: 1
ISSN: 0090-4295
Publisher: Elsevier Science, Inc.  
Date Published: 2014-07-01
Start Page: 158
End Page: 163
Language: English
DOI: 10.1016/j.urology.2014.02.049
PROVIDER: scopus
PMCID: PMC4095774
PUBMED: 24824411
DOI/URL:
Notes: Export Date: 1 August 2014 -- CODEN: URGYA -- Source: Scopus
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  1. Jaspreet Sandhu
    138 Sandhu
  2. John P Mulhall
    601 Mulhall
  3. Andrew J Vickers
    880 Vickers
  4. Matthew T Kent
    26 Kent