Abstract: PD18-02
Sources of Funding: Blue Cross and Blue Shield of Michigan and grant 1T32-CA180984 from the National Cancer Institute.

Introduction

The Michigan Urological Surgery Improvement Collaborative established its patient reported outcomes program (MUSIC PRO) with the dual objectives of systematically measuring and improving population-level urinary and sexual function outcomes after radical prostatectomy (RP). Herein, we report statewide outcomes from the first-year after RP and examine differences in patient-reported urinary function (UF) across surgeons to identify initial improvement opportunities.

Methods

Initiated in 2014, MUSIC PRO involves electronic collection of validated questionnaire data from men treated in 23 diverse academic and community urology practices. Men are surveyed at baseline, 3, 6, 12, and 24 months after RP. For all MUSIC PRO patients, we determined the proportion reporting good overall UF (score range 0-21, good function ≥ 17) and good overall erectile function (EF) (score range 0-30, good function ≥22) at baseline and during the first year after RP. After limiting the cohort to include only men treated by surgeons with ≥10 patients having good baseline UF, we evaluated surgeon-specific differences in the proportion of patients returning to good UF by 3 months post-operatively.

Results

From 4/2014 through 10/2016, 1,593 and 1,447 men completed baseline UF and EF surveys, respectively. Throughout the first year, response rates varied from 83-97%. At baseline, 77.6% of men reported good UF. While only 38.9% of men report similar good UF at 3 months post-RP, this proportion is much closer to baseline one year from surgery (65.3%) (Figure 1a). For EF, 58.6% of patients reported good function at baseline; this proportion decreased to 10.6% at 3 months, and then improved progressively to 21.8% after one year (Figure 1a). Across 21 MUSIC surgeons, there was broad variation in the proportion of patients reporting a return to good UF by 3 months (range 0-63.9% p<0.001) (Figure 1b).

Conclusions

Across the state of Michigan, most men recover baseline levels of good urinary function, but not sexual function, during the first 12 months after radical prostatectomy. Surgeon-specific differences in short-term urinary control outcomes highlight a quality improvement opportunity being addressed through continued measurement, technical assessments and refinements, and survivorship interventions.

Funding

Blue Cross and Blue Shield of Michigan and grant 1T32-CA180984 from the National Cancer Institute.