Factors affecting change in quality of life after prostatectomy for XXXX : the impact of surgical techniques.

@entity1 @entity6 @entity1067 @entity86 @entity4623
PURPOSE: The impact of prostatectomy on quality of life was assessed in @entity1 with @entity1067 ( @entity1067 ) who were classified according to the expected benefit from surgical intervention. The relative impact of the 2 surgical techniques (open versus closed) on short-term quality of life was compared. MATERIALS AND METHODS: An observational study was done on 545 consecutive @entity1 with @entity1067 undergoing prostatectomy at 3 medical centers in Israel between 1991 and 1992. Repeated structured interviews preoperatively, and at 4 and 12 months postoperatively were performed, including 6 quality of life questionnaires evaluating @entity1067 specific (symptom severity and symptom effect) and generic (activity, independence, mental health and health perception) parameters. In addition, the interviews consisted of socio-demographic data elements. Clinical details regarding severity of @entity4623 and co-morbidity were obtained from the medical charts. RESULTS: We found a correlation between postoperative change in symptom effect and in generic quality of life measures (r-0.11 to 0.20, p < 0.04). The postoperative decrease in the mean symptom effect score was 56% and 52% for severe and moderate preoperative levels, respectively. There was no decrease in the mean symptom effect score for the mild preoperative level (18% of these @entity1 had @entity86 ). A secondary operation, and the @entity6 and poor activity level were risk factors for lack of improvement in @entity1 with moderate preoperative symptom effects. We found that the impact of open prostatectomy on quality of life was similar to that of the closed technique after adjustment for @entity1 attributes, except for those with an indwelling urinary catheter in whom an open operation was advantageous. CONCLUSIONS: In @entity1 with @entity1067 and mild symptom effects, and in subgroups of @entity1 with moderate symptom effects surgery should not be recommended. Based on short-term measures of quality of life there is no justification for a preference between open and closed operations.
