Introduction

Robot-assisted radical prostatectomy (RARP) has been reported to be associated with less incontinence than a retropubic radical prostatectomy (RRP) and laparoscopic radical prostatectomy (LRP); however, urinary continence continues to occur at a constant rate. There are few reports of urinary incontinence following a RARP to perform a detailed examination of the impact on the patients’ postoperative quality of life (QOL). Therefore, in this study, we examined the association between health-related QOL and urinary continence following RARP.

Methods

From October 2010 to August 2016, 319 patients underwent RARP at our hospital. An SF-8 evaluation was performed for 154 retrospectively selected patients with observable data for 24 months (preoperative, and postoperative 1, 3, 6, 9, 12, and 24-month evaluations) for our analysis. Evaluation items: physical function (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role emotional (RE), mental health (MH), physical component summary (PCS), and mental component summary (MCS) were compared before and after surgery. In addition, “pad free” was defined as no incontinence, and we examined the relationship between the postoperative urinary continence and SF-8 data.

Results

The average age at surgery was 65 (range: 48–76) years, the average preoperative PSA was 9.16 ng/mL (range: 1.17–35.4), and the average prostate volume was 31.6 mL (range: 11–131). We observed a significant reduction at one month post-surgery compared with the preoperative values for all of the scores (all p < 0.0001), and the values recovered to the preoperative status between 3 and 12 months after surgery. The BP, GH, RE, MH and MCS were significantly increased compared with the preoperative values (BP: after nine months; GH: after nine months; RE: after 18 months; MH: after three months; and, MCS: at 12 months). For the group that achieved a pad-free status, the GH, VT, SF, and MH were significantly higher compared to those in the non-achievement group one month after surgery. Moreover, the RF, RP, RE, and MCS were significantly higher in the pad-free achieving group after three months after surgery. Significant differences in BP were not recognized after surgery between the two groups.

Conclusions

Although all of the scores significantly decreased within one month post-surgery, the values recovered to the preoperative score within 12 months. No urinary continence after surgery appears to be associated with a favorable recovery of patient QOL following RARP.

Funding

none