Klorek Tobiasz, Schlichte Anton N J H, Peter Cornelia, Jahnen Matthias, Dinkel Andreas, Schiele Stefan, Lunger Lukas, Schulwitz Helga, Gschwend Jürgen E, Herkommer Kathleen
Klinik und Poliklinik für Urologie, Technische Universität München, School of Medicine, TUM Universitätsklinikum rechts der Isar, Ismaninger Straße 22, 81675, München, Deutschland.
Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Technische Universität München, School of Medicine, TUM Universitätsklinikum rechts der Isar, München, Deutschland.
Urologie. 2025 Jan;64(1):29-37. doi: 10.1007/s00120-024-02441-0. Epub 2024 Sep 20.
Radical prostatectomy (RP) is one of the most common therapeutic strategies for treating localized prostate cancer (PCa). Currently, the significance of postoperative functional limitations for affected patients in the long-term course, especially in comparison to age-related comorbidities, is unclear.
The aim of this study was to quantify the prevalence of subjective health restrictions alongside functional deficits in long-term PCa survivors after RP and their relevance for subjective impairments in everyday life.
Using the German version of the Self-Administered Comorbidity Questionnaire (SCQ-D), 3173 long-term survivors after RP reported their comorbidities in 13 predefined categories and in 3 free-text fields along the dimensions "problem," "treatment," and "impairment".
The mean age at survey was 79.5 years (standard deviation, SD ± 6.4), with a mean time since RP of 17.4 years (SD ± 3.7). The three most frequently identified comorbidities/percentage of patients who felt impaired were: hypertension (62.2%/8.5%), back pain (44.1%/54.5%), and osteoarthritis (36.1%/54.1%). The most frequently mentioned additional health problems can be subsumed under the umbrella term "urological problems" (6.1%/72.7%): incontinence (4.8%/74.3%), bladder problems (1.1%/61.8%), and erectile dysfunction (0.5%/47.1%).
In summary, non-cancer-related comorbidities in the long-term course after RP are often perceived as "problems" but rarely lead to subjective impairment. In contrast, treatment-related urological problems are rarely reported as "problems", but they very often lead to subjective impairment in everyday life.
根治性前列腺切除术(RP)是治疗局限性前列腺癌(PCa)最常见的治疗策略之一。目前,术后功能受限对受影响患者长期病程的影响,尤其是与年龄相关的合并症相比,其意义尚不清楚。
本研究的目的是量化RP术后长期PCa幸存者主观健康限制以及功能缺陷的患病率,及其与日常生活中主观障碍的相关性。
使用德文版的自我管理合并症问卷(SCQ-D),3173例RP术后长期幸存者报告了他们在13个预定义类别以及沿着“问题”“治疗”和“损害”维度的3个自由文本字段中的合并症情况。
调查时的平均年龄为79.5岁(标准差,SD±6.4),自RP术后的平均时间为17.4年(SD±3.7)。三种最常被识别出的合并症/感觉受到损害的患者百分比分别为:高血压(62.2%/8.5%)、背痛(44.1%/54.5%)和骨关节炎(36.1%/54.1%)。最常提到的其他健康问题可归为“泌尿系统问题”这一统称(6.1%/72.7%):尿失禁(4.8%/74.3%)、膀胱问题(1.1%/61.8%)和勃起功能障碍(0.5%/47.1%)。
总之,RP术后长期病程中与癌症无关的合并症常被视为“问题”,但很少导致主观障碍。相比之下,与治疗相关的泌尿系统问题很少被报告为“问题”,但它们在日常生活中常常导致主观障碍。