Patient- and Surgeon-Level Variation in Patient-Reported Sexual Function Outcomes Following Radical Prostatectomy...

Area of Science:

• Urology
• Surgical Outcomes Research
• Patient-Reported Outcomes

Background:

• Sexual function is a critical patient-reported outcome after radical prostatectomy, significantly affecting quality of life.
• Understanding variations in sexual function outcomes at both patient and surgeon levels is crucial for quality improvement initiatives.

Purpose of the Study:

• To describe patient- and surgeon-level sexual function outcomes following radical prostatectomy within the Michigan Urological Surgery Improvement Collaborative (MUSIC).
• To examine the correlation between surgeon case volume and sexual function outcomes in this patient cohort.

Main Methods:

• Prospective cohort study utilizing the MUSIC registry and patient-reported sexual function data.
• Validated questionnaires collected sexual function data pre-surgery and at 3, 6, 12, and 24 months post-surgery.
• Analysis included patient demographics, race/ethnicity, and surgeon-level variations in outcomes.

Main Results:

• Sexual function scores (EPIC-26) at 12 and 24 months did not return to baseline levels for patients undergoing bilateral nerve-sparing radical prostatectomy.
• Significant patient- and surgeon-level variations in sexual function outcomes and recovery rates were observed at 12 and 24 months.
• No significant correlation was found between surgeon case volume and sexual function outcomes; younger age, lower baseline scores, lower Gleason score, and nonobesity were associated with better recovery.

Conclusions:

• Significant patient- and surgeon-level variability exists in sexual function recovery following radical prostatectomy.
• Surgeon-level variations in sexual function outcomes present a valuable opportunity for collaborative quality improvement in urological surgery.