Self-reported quality of recovery after radical prostatectomy-a prospective cohort study

The Quality of Recovery-15 questionnaire (QoR-15) has been developed to assess patient-reported recovery 24 h after non-cardiac surgery. This prospective cohort study sought to analyze patient-reported recovery throughout day five after open radical retropubic prostatectomy (ORP) and robot-assisted radical retropubic prostatectomy (RARP).

Between June 2022 and February 2023 adult patients, who were scheduled for elective radical prostatectomy, completed the German version of the QoR-15 (QoR-15GE) preoperatively to establish a baseline value. Between postoperative day one and day five, patients completed the QoR-15GE daily until the day of discharge.

A total of 523 patients completed the questionnaires. On postoperative day one QoR-15GE scores were significantly lower after RARP compared with ORP (ORP: 113 ± 22 vs. RARP: 107 ± 24; p = 0.006) with a higher decline in postoperative QoR-15GE scores in RARP compared with ORP patients (ORP: 27 ± 20 vs. RARP: 32 ± 23; p = 0.006). The multivariable analysis confirmed an influence of surgical technique (Estimate: 4.39; 95% CI [0.27; 8.50], p = 0.037) on postoperative quality of recovery after adjusting for clinically relevant variables. Irrespective of surgical technique, we observed a consistent increase in QoR-15GE scores with similar recovery scores on postoperative days three, four, and five.

Patients who undergo RARP experience poorer postoperative recovery at postoperative days one and two compared to those undergoing ORP. However, recovery scores align from postoperative day three, indicating a similar level of patient-reported recovery before hospital discharge. These findings suggest that the QoR-15GE may be appropriate for serial assessments.