Ponholzer Anton, Brössner Clemens, Struhal Gerhard, Marszalek Martin, Madersbacher Stephan
Department of Urology and Andrology, Ludwig Boltzmann Institute for Urological Oncology, Donauspital - SMZO, Langobardenstrasse 122, 1220, Vienna, Austria.
World J Urol. 2006 Aug;24(3):325-30. doi: 10.1007/s00345-006-0075-1. Epub 2006 Apr 11.
The objective of this study was to assess lower urinary tract symptoms (LUTS), urinary incontinence (UI), erectile dysfunction (ED) and quality of life after radical prostatectomy (RPE) and external beam radiation therapy (EBRT) in a "real-life" setting. A consecutive series of patients undergoing routine follow-up after RPE and EBRT at 28 Austrian institutions were analyzed. Men who received adjuvant therapy were excluded. All patients completed a questionnaire on (a) LUTS and UI, (b) sexual function and (c) quality of life. A total of 364 patients following RPE and 82 after EBRT entered this study and were compared in a matched pair analysis (1:1) based on age, PSA at diagnosis and follow-up (RPE: n=82; EBRT: n=82). Mean time-interval between treatment and current investigation was 4.6 years for RPE and 4.4 years for EBRT (n.s.). UI was reported by 41.3% after RPE and 18.8% after EBRT (P=0.001). Urgency was more frequent after EBRT, this difference, however, did not reach statistical significance. Moderate to severe ED (IIEF-5, <17) was present in 80.0% after RPE and in 80.8% after EBRT (n.s.). On a ten-point scale, RPE-patients rated their quality of life higher (7.3) than after EBRT (6.7) (P=0.01). In this "real-life" setting, RPE and EBRT had significant, yet divergent effects on LUTS, UI and sexual function. The respective numbers were substantially higher than those usually reported by physician-directed studies and centers of excellence.
本研究的目的是在“现实生活”环境中评估根治性前列腺切除术（RPE）和体外放射治疗（EBRT）后的下尿路症状（LUTS）、尿失禁（UI）、勃起功能障碍（ED）及生活质量。对奥地利28家机构中接受RPE和EBRT后进行常规随访的一系列连续患者进行了分析。排除接受辅助治疗的男性。所有患者均完成了一份关于（a）LUTS和UI、（b）性功能以及（c）生活质量的问卷。共有364例RPE术后患者和82例EBRT术后患者进入本研究，并根据年龄、诊断时及随访时的前列腺特异性抗原（PSA）进行配对分析（1:1）（RPE组：n = 82；EBRT组：n = 82）。RPE组治疗与当前调查的平均时间间隔为4.6年，EBRT组为4.4年（无统计学差异）。RPE术后报告有UI的患者占41.3%，EBRT术后为18.8%（P = 0.001）。EBRT术后尿急更为常见，但这种差异未达到统计学意义。RPE术后80.0%的患者存在中度至重度ED（国际勃起功能指数-5，<17），EBRT术后为80.8%（无统计学差异）。在10分制评分中，RPE组患者对其生活质量的评分（7.3）高于EBRT组（6.7）（P = 0.01）。在这种“现实生活”环境中，RPE和EBRT对LUTS、UI和性功能有显著但不同的影响。各自的数字明显高于医生主导的研究和卓越中心通常报告的数字。
