[Stool behaviour and local pain after radical perineal and retroperitoneal prostatectomy].

PURPOSE: One of the main therapeutic targets of a radical prostatectomy (RP) as a treatment for -localised prostate cancer is the maintenance of quality of life after surgery besides the known oncological and functional effects. This prospective study compared the quality of life after surgery of patients treated with two different surgical methods (perineal RP, RPP; retropubic RP, RRP). The aim of this study was to compare perineal and retropubic RP with regard to stool behaviour and local pain symptoms. PATIENTS AND METHODS: 257  radical prostatectomies (169 RPP, 88 RRP) were performed between July 2003 and December 2004. 208 (151 RPP, 57 RRP) prospectively evaluated patients replied to a physician-independent validated questionnaire (QLQ-C30 with prostate modul, IIEF 75, stool behaviour) followed by a phone survey regarding the continence of all 257  patients.
RESULTS: One year after surgery, the complete continence rate (no pads) was 75 % for the RPP group and 61 % for the RRP group. 22 % of the patients reported involuntary stool leakage in the RPP group and 19 % in the RRP group (not significantly different). 29 % of the patients in the RPP group complained of local pain after 12  months, one third of them while sitting. In the RRP group, 28 % of the patients complained of local pain after 12  months, 15 % of them while sitting.17 % in the RPP and 27 % in the RRP group who suffered of stool leakage had these symptoms preoperatively. One year after surgery, 52 % of preoperatively potent patients were still potent after nerve-sparing RPP and 40 % were potent after nerve-sparing RRP. 78 % of patients in the RPP group and 67 % in the RRP group had an overall satisfactory quality of life.
CONCLUSION: The application of different surgical methods did not differ with regard to postoperative local pain, stool behaviour, or general health items of quality of life. Stool leakage and perineal pain while sitting were not limited to RPP only and about a quarter of these patients had suffered from stool leakage already be-fore surgery. © Georg Thieme Verlag KG Stuttgart ˙ New York.