Radical Prostatectomy Survivorship: What Are We Really Asking?

Area of Science:

• Urology
• Oncology
• Patient Outcomes

Background:

• Radical prostatectomy (RP) for prostate cancer (PCa) can lead to significant survivorship issues including urinary incontinence, sexual dysfunction, and bowel dysfunction.
• Thorough discussion and documentation of these outcomes are vital for patient management and quality of life.

Purpose of the Study:

• To audit the completeness of outpatient discussions and medical record documentation regarding urinary, sexual, and bowel function survivorship outcomes in patients following RP.
• To identify potential disparities in the discussion of these outcomes based on patient demographics.

Main Methods:

• A retrospective audit of 253 radical prostatectomies (RP) performed between 2014 and 2018 at two Australian tertiary institutions.
• Electronic medical records were reviewed at five time points: pre-operative, and 6 weeks, 3 months, 6 months, and 12 months post-RP.
• Key outcomes measured were the rates of documented discussions concerning urinary incontinence, sexual dysfunction, and bowel dysfunction.

Main Results:

• At 6 weeks post-RP, documented discussions occurred for 86% of urinary, 47% of sexual, and 27% of bowel functions.
• Averaged across 12 months post-RP, documented discussions were 73% for urinary, 45% for sexual, and 14% for bowel function.
• Discussions of sexual and bowel function were significantly less frequent in men over 65 compared to those under 65.

Conclusions:

• Urinary incontinence outcomes are more consistently discussed and documented post-RP than sexual and bowel dysfunction.
• There is a need to improve the systematic documentation of sexual and bowel function discussions in prostate cancer survivorship care.
• Age appears to be a factor influencing the discussion of sexual and bowel function post-prostatectomy.