MP37-13 WHEN AND WHY DO MEN REGRET HAVING RADICAL PROSTATECTOMY?

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy I (MP37)1 May 2024MP37-13 WHEN AND WHY DO MEN REGRET HAVING RADICAL PROSTATECTOMY? Helen W. Cui, Yuchen Liu, Jeffrey Sun, Kola Olugbade, Angela Estevez, Gabriela Nieto-Blanco, Catrina Crociani, Sarah Duncan, Phillip Kim, Utsav K. Bansal, Boris Gershman, Andrew A. Wagner, and Peter Chang Helen W. CuiHelen W. Cui , Yuchen LiuYuchen Liu , Jeffrey SunJeffrey Sun , Kola OlugbadeKola Olugbade , Angela EstevezAngela Estevez , Gabriela Nieto-BlancoGabriela Nieto-Blanco , Catrina CrocianiCatrina Crociani , Sarah DuncanSarah Duncan , Phillip KimPhillip Kim , Utsav K. BansalUtsav K. Bansal , Boris GershmanBoris Gershman , Andrew A. WagnerAndrew A. Wagner , and Peter ChangPeter Chang View All Author Informationhttps://doi.org/10.1097/01.JU.0001008948.02935.01.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Effective counselling prior to robot-assisted laparoscopic radical prostatectomy (RALP) is crucial in setting expectations for patients' health related quality of life (HRQOL) outcomes postoperatively. Given that clinicians are known to underestimate the severity of HRQOL deficits after RALP, we aimed to compare patients' recovery after RALP to their preoperative expectations. In addition, we evaluated decision regret after RALP as a function of patients' expectations compared to actual recovery. METHODS: We prospectively enrolled 136 patients in a single institution, IRB approved study between 2019-22. Prior to RALP, subjects completed 3-month and 12-month "predictive" EPIC-CP (Expanded Prostate Cancer Index Composite for Clinical Practice) questionnaires, representing their post-operative HRQOL expectations. Subjects then completed EPIC-CP at 3- and 12-months after surgery, representing their actual post-operative HRQOL outcomes. Subjects completed the Decision Regret Scale 12 months post-operatively. We evaluated differences between the predictive and actual scores of each EPIC-CP domain using the Wilcoxon Rank Sum Test. Decision regret was dichotomized as 'low regret' (score 0-15) or 'high regret' (score >15). RESULTS: Three months post-operatively, patients' actual recovery was better than they predicted in all EPIC-CP domains (p<0.05) except sexual function. However, by 12 months there was no significant difference between patient-predicted and actual EPIC-CP scores except for in the sexual function domain, for which actual symptom severity was worse than expected (Table 1). At 12 months, 80% had low decision regret and 20% had high decision regret. Worse than predicted symptom severity in the sexual domain at 12 months was associated with high regret score (Chi-squared test p=0.044). CONCLUSIONS: Twelve months after RALP, recovery of urinary function matches preoperative patient expectations, while sexual function is worse than predicted. Although overall patient decision regret was low, worse than predicted sexual function scores were associated with high decision regret. These results suggest that improved preoperative counselling regarding sexual recovery is needed. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e607 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Helen W. Cui More articles by this author Yuchen Liu More articles by this author Jeffrey Sun More articles by this author Kola Olugbade More articles by this author Angela Estevez More articles by this author Gabriela Nieto-Blanco More articles by this author Catrina Crociani More articles by this author Sarah Duncan More articles by this author Phillip Kim More articles by this author Utsav K. Bansal More articles by this author Boris Gershman More articles by this author Andrew A. Wagner More articles by this author Peter Chang More articles by this author Expand All Advertisement PDF downloadLoading ...