Department of Urology, Ludwig-Maximilians-University, Marchioninistrasse 15, 81377, Munich, Germany.
Department of Urologic Sciences, The Vancouver Prostate Centre, University of British Columbia, 2660 Oak Street, Vancouver, BC, V6H3Z6, Canada.
World J Urol. 2017 Aug;35(8):1205-1212. doi: 10.1007/s00345-016-1998-9. Epub 2017 Jan 16.
To evaluate patient-reported functional outcomes after radical prostatectomy (RP) and to analyse the effect of perioperative patient education on satisfaction rates among low-risk prostate cancer patients.
Inclusion criteria encompassed low-risk prostate cancer patients as defined by the D'Amico criteria, undergoing nerve-sparing RP without pelvic lymph node dissection. Patient-centred functional outcomes, subjective evaluation of perioperative counselling, and patient satisfaction rates were documented. Stress urinary incontinence (SUI) was assessed by daily pad usage. Erectile dysfunction (ED) was assessed using IIEF5 score. Patients' histories were attained from the electronic medical records. The effect of pre-defined predictive features for satisfaction rates was analysed in low-risk patients. Statistical analyses included Fisher's exact test, Mann-Whitney-U test, and binary logistic regression models (p < 0.05).
266 patients met the inclusion criteria. Median follow-up was 94 months (68-118). The global satisfaction rate was 75.1%. Regarding SUI, 69.5% of patients required no pads. 67.1% felt very well informed, while 11.7% felt poorly educated about postoperative SUI. Regarding ED, an IIEF score of ≥18 was reached by 33.7%. 59.6% felt very well educated, while 13.0% felt poorly informed. Poor patient counselling regarding SUI and ED led to significantly decreased long-term satisfaction rates [40.7, 33.3% (p < 0.001)]. In multivariate analysis, poor ED patient counselling [OR 0.190, 95% CI 0.055-0.652 (p = 0.008)], and postoperative IIEF5 score [OR 3.061, 95% CI 1.013-3.111 (p = 0.013)] could be confirmed as independent predictors for patient satisfaction.
Patient-centred functional outcome analysis has illustrated the importance of perioperative patient education on long-term patient satisfaction rates after RP in low-risk prostate cancer patients.
评估根治性前列腺切除术（RP）后患者报告的功能结果，并分析围手术期患者教育对低危前列腺癌患者满意度的影响。
纳入标准包括符合 D'Amico 标准的低危前列腺癌患者，行保留神经的 RP 术且无盆腔淋巴结清扫术。记录患者为中心的功能结果、围手术期咨询的主观评价和患者满意度。通过日常垫的使用评估尿失禁（SUI），使用 IIEF5 评分评估勃起功能障碍（ED）。患者病史来自电子病历。分析低危患者满意度的预定义预测特征的影响。统计分析包括 Fisher 确切检验、Mann-Whitney-U 检验和二元逻辑回归模型（p<0.05）。
266 例患者符合纳入标准。中位随访时间为 94 个月（68-118）。总体满意度为 75.1%。在 SUI 方面，69.5%的患者无需使用垫。67.1%的患者感觉接受了很好的教育，而 11.7%的患者感觉对术后 SUI 的教育很差。在 ED 方面，33.7%的患者达到 IIEF 评分≥18。59.6%的患者感觉接受了很好的教育，而 13.0%的患者感觉对 ED 的教育很差。SUI 和 ED 的患者咨询不佳导致长期满意度显著降低[40.7%，33.3%（p<0.001）]。多变量分析显示，ED 患者咨询差[OR 0.190，95%CI 0.055-0.652（p=0.008）]和术后 IIEF5 评分[OR 3.061，95%CI 1.013-3.111（p=0.013）]可作为患者满意度的独立预测因素。
以患者为中心的功能结果分析表明，围手术期患者教育对低危前列腺癌患者 RP 后长期患者满意度具有重要意义。
