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评估决策辅助工具使用对前列腺癌术后患者报告结局的影响。

Assessing the Impact of Decision Aid Use on Post Prostatectomy Patient Reported Outcomes.

机构信息

Department of Urology, University of Michigan, Ann Arbor, MI; VA Ann Arbor Medical Center, Ann Arbor, MI.

Department of Urology, University of Michigan, Ann Arbor, MI; VA Ann Arbor Medical Center, Ann Arbor, MI.

出版信息

Urology. 2022 Jul;165:187-192. doi: 10.1016/j.urology.2022.02.008. Epub 2022 Feb 24.

Abstract

OBJECTIVE

To evaluate whether completing a decision aid, Personal Patient Profile - Prostate (P3P), prior to prostatectomy, affects self-reported bother from post-prostatectomy urinary incontinence and erectile dysfunction.

MATERIALS AND METHODS

This retrospective analysis included data from men with newly diagnosed clinically localized, very low to intermediate risk prostate cancer who elected for prostatectomy within the Michigan Urological Surgery Improvement Collaborative between 2018-2021. Multivariable logistic regression models were used to estimate the association between P3P use and bother from post prostatectomy erectile dysfunction and urinary incontinence as measured by the Expanded Prostate Cancer Index Composite (EPIC-26).

RESULTS

Among the 3987 patients included, 7% used P3P (n = 266). Men who used P3P reported significantly less bother from erectile dysfunction at 6 months vs non-users (aOR 0.42 [95% CI 0.27-0.66]). At 12 months, the effect of P3P on bother from erectile dysfunction was not statistically significant (aOR 0.62 [95% CI 0.37-1.03]). Men who used P3P did not have a statistically significant difference in bother from urinary incontinence (3-month: aOR 0.56 [95% CI 0.30-1.06]; 6-month; aOR 0.79 [95% CI 0.31-1.97]).

CONCLUSION

Within the stated limitations of this study, we find that use of a decision aid for localized prostate cancer was associated with decreased odds of men being bothered from sexual dysfunction but not urinary incontinence at 6 months post prostatectomy.

摘要

目的

评估在前列腺切除术之前完成决策辅助工具,即个人患者前列腺状况简介(P3P),是否会影响前列腺切除术后尿失禁和勃起功能障碍的自我报告困扰程度。

材料和方法

本回顾性分析纳入了 2018 年至 2021 年期间在密歇根州泌尿外科学术改进合作组织中选择前列腺切除术的新发临床局限性、极低至中度风险前列腺癌男性患者的数据。多变量逻辑回归模型用于估计 P3P 使用与前列腺切除术后勃起功能障碍和尿失禁困扰之间的关联,以扩展前列腺癌指数综合量表(EPIC-26)进行测量。

结果

在纳入的 3987 例患者中,有 7%(n=266)使用了 P3P。与非使用者相比,使用 P3P 的男性在 6 个月时报告的勃起功能障碍困扰程度显著降低(优势比 0.42 [95%置信区间 0.27-0.66])。在 12 个月时,P3P 对勃起功能障碍困扰程度的影响没有统计学意义(优势比 0.62 [95%置信区间 0.37-1.03])。使用 P3P 的男性在尿失禁困扰程度方面没有统计学上的显著差异(3 个月:优势比 0.56 [95%置信区间 0.30-1.06];6 个月:优势比 0.79 [95%置信区间 0.31-1.97])。

结论

在本研究的既定限制范围内,我们发现使用局部前列腺癌决策辅助工具与前列腺切除术后 6 个月男性性功能障碍困扰的可能性降低相关,但与尿失禁无关。

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