Investigators evaluate patient-reported functional outcomes after prostatectomy across eras


“With regards to urinary function, there were actually no differences between the 2 eras. We thought that was a little surprising,” says Udit Singhal, MD.

In this video, Udit Singhal, MD, shares notable findings from the recent Journal of Urology study “Comparing patient-reported functional outcomes after radical prostatectomy in historical and contemporary practice.” Singhal is a urologic oncology fellow at Mayo Clinic in Rochester, Minnesota.


What were some of the notable findings? Were any of them surprising to you and your coauthors?

Generally, we compared 2 different eras. We've compared an era that we considered the historical era, in which we analyzed patients from 2003 to 2006. The majority of those patients actually had undergone open radical prostatectomy, and 40% underwent robotic radical prostatectomy. And then we compared that to what we considered a more contemporary era, which was the MUSIC cohort in our study, which was analyzed between 2016 to 2018. When comparing those eras, we really wanted to understand whether there were differences in urinary function recovery, or sexual function recovery for patients after prostatectomy. When we did that analysis, we found that there was actually a difference with regards to recovery of sexual function for patients in the contemporary era, meaning that patients who had more contemporary surgery did better with regards to recovery of their sexual function, compared with patients in the historical era. But with regards to urinary function, there were actually no differences between the 2 eras. We thought that was a little surprising. There are studies that have shown some improvement with regards to urinary function over time. There's 1 specific study from Memorial Sloan Kettering Cancer Center that showed that there was improvement with regards to severe urinary incontinence with time, meaning that patients that had surgery more recently, were actually doing a little bit better with regards to urinary function. And we expected the same within our cohort and in our analysis, but we found that there was actually no difference. And so perhaps we haven't really gotten better as surgeons, despite the availability of robotic surgery or other dynamic changes that have occurred over time. We may have not gotten better at improving patients' urinary function, but it seems that potentially we've gotten better at allowing patients to have better sexual function after prostate cancer surgery. There could be a variety of different reasons for that. Our study doesn't really answer why that may be the case. Some of it was potentially expected, but some of it may not be as expected that we didn't really actually improve patients with regards to urinary function.

This transcript was edited for clarity.

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