Department of Urology, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
Department of Health Services Research, Carl Von Ossietzky University, Ammerlaender Heerstrasse 140, 26111, Oldenburg, Germany.
World J Urol. 2021 Aug;39(8):2929-2936. doi: 10.1007/s00345-020-03526-z. Epub 2020 Dec 1.
Treatment of post-prostatectomy urinary incontinence (UI) and erectile dysfunction (ED) increases quality of life (QoL). Aim of our study was to evaluate the utilisation of care among patients with post-prostatectomy UI and ED in Germany.
The HAROW study documented treatment of patients with localised prostate cancer (≤ T2c) in Germany. 1260 patients underwent radical prostatectomy (RP). Patients answered validated questionnaires after a median follow-up of 6.3 years. Response rate was 76.8%.
Median age at RP was 65 (IQR 60-69) years. 14% (134/936) used more than one pad per day for UI. 25% (26/104, 30 missing) of UI patients underwent surgery to improve continence. Of patients without surgery, 41% (31/75) reported a moderate-to-severe issue concerning their incontinence with worse mental health and QoL. 81% (755/936) patients were unable to have an erection firm enough for sexual intercourse. Of all ED patients, 40% (319/793) used ED treatment regularly or tried it at least once. 49% (243/499) of patients with interest in sex never tried ED treatment. In multivariate analysis, patients not using ED treatments were older (≥ 70 years OR 4.1), and more often had preoperative ED (OR 2.3) and less interest in sex (OR 2.2). Nevertheless, 30% (73/240) of these patients had moderate-to-severe issues with their ED reporting worse mental health and QoL.
Almost half of the patients without post-prostatectomy UI and ED treatment reported moderate-to-severe issues with a significant decrease in QoL. This indicates an insufficient utilisation of care in Germany.
治疗前列腺切除术后尿失禁（UI）和勃起功能障碍（ED）可提高生活质量（QoL）。我们的研究旨在评估德国前列腺切除术后 UI 和 ED 患者的护理利用情况。
HAROW 研究记录了德国局限性前列腺癌（≤T2c）患者的治疗情况。1260 名患者接受了根治性前列腺切除术（RP）。患者在中位随访 6.3 年后回答了经过验证的问卷。应答率为 76.8%。
RP 时的中位年龄为 65（IQR 60-69）岁。14%（134/936）每天使用超过一个尿垫用于 UI。25%（26/104，30 例缺失）的 UI 患者接受手术改善控尿。未手术的患者中，41%（31/75）报告其失禁问题中度至重度，心理健康和 QoL 更差。81%（755/936）的患者无法进行足够坚硬的勃起以进行性交。所有 ED 患者中，40%（319/793）定期使用 ED 治疗或至少尝试过一次。49%（243/499）有性兴趣的患者从未尝试过 ED 治疗。多变量分析显示，未使用 ED 治疗的患者年龄较大（≥70 岁 OR 4.1），术前 ED 更常见（OR 2.3），性兴趣较低（OR 2.2）。然而，这些患者中有 30%（73/240）报告其 ED 中度至重度，心理健康和 QoL 显著下降。
近一半未接受前列腺切除术后 UI 和 ED 治疗的患者报告存在中度至重度问题，生活质量显著下降。这表明德国护理的利用不足。
