Koji Amano1,2, Kumi Suzuki3, Yuri Ito4. 1. Doctoral Program, Graduate School of Nursing, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan. kamano@dwc.doshisha.ac.jp. 2. Doshisha Women's College of Liberal Arts, Faculty of Nursing, Kyotanabe, Kyoto, Japan. kamano@dwc.doshisha.ac.jp. 3. Faculty of Nursing, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan. 4. Department of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.
Abstract
PURPOSE: This study aimed to clarify associations between and changes over time in lower urinary tract symptoms (LUTS) and quality of life (QOL) in cancer patients after a total prostatectomy. METHODS: The subjects were cancer patients who had undergone total prostatectomy and had participated in non-randomized controlled trials, cohort studies, or case-control studies with outcomes of changes over time in LUTS or QOL. Fourteen studies were included for systematic review and meta-analysis. RESULTS: Compared to preoperatively, the International Prostate Symptom Score (IPSS)-a LUTS indicator-yielded the following, 3 months after operation (MD [95% confidence interval, CI] = -0.27 [-2.22 to 1.68], p = .7855), 6 months after operation (MD [95% CI] = -2.12 [-3.04 to -1.20], p < .0001), and 12 months after operation (MD [95% CI] = -2.27 [-2.63 to -1.92], p < .0001), demonstrating significant decrease and, therefore, improvement of symptoms after 6 months. International Prostate Symptom Score-Quality of Life (IPSS-QOL), a QOL indicator, was significantly reduced at 12 months after surgery, indicating improved QOL (MD [95% CI] = -0.49 [-0.87 to -0.11], p = .0107), but there was heterogeneity between different studies (I2 = 89.19%). A cumulative meta-analysis showed a tendency for greater improvements in IPSS-QOL at 12 months after surgery, the older the mean age and the higher the mean pre-surgery IPSS. Factors of age, prostate volume, and pre-surgery IPSS were related to postoperative LUTS; exacerbation of both urinary incontinence and urinary tract obstruction was related to QOL. CONCLUSION: While LUTS improves over time after total prostatectomy, it takes 6 to 12 months after surgery. As there is an association between LUTS and QOL, support to promote self-management of LUTS is important.
PURPOSE: This study aimed to clarify associations between and changes over time in lower urinary tract symptoms (LUTS) and quality of life (QOL) in cancer patients after a total prostatectomy. METHODS: The subjects were cancer patients who had undergone total prostatectomy and had participated in non-randomized controlled trials, cohort studies, or case-control studies with outcomes of changes over time in LUTS or QOL. Fourteen studies were included for systematic review and meta-analysis. RESULTS: Compared to preoperatively, the International Prostate Symptom Score (IPSS)-a LUTS indicator-yielded the following, 3 months after operation (MD [95% confidence interval, CI] = -0.27 [-2.22 to 1.68], p = .7855), 6 months after operation (MD [95% CI] = -2.12 [-3.04 to -1.20], p < .0001), and 12 months after operation (MD [95% CI] = -2.27 [-2.63 to -1.92], p < .0001), demonstrating significant decrease and, therefore, improvement of symptoms after 6 months. International Prostate Symptom Score-Quality of Life (IPSS-QOL), a QOL indicator, was significantly reduced at 12 months after surgery, indicating improved QOL (MD [95% CI] = -0.49 [-0.87 to -0.11], p = .0107), but there was heterogeneity between different studies (I2 = 89.19%). A cumulative meta-analysis showed a tendency for greater improvements in IPSS-QOL at 12 months after surgery, the older the mean age and the higher the mean pre-surgery IPSS. Factors of age, prostate volume, and pre-surgery IPSS were related to postoperative LUTS; exacerbation of both urinary incontinence and urinary tract obstruction was related to QOL. CONCLUSION: While LUTS improves over time after total prostatectomy, it takes 6 to 12 months after surgery. As there is an association between LUTS and QOL, support to promote self-management of LUTS is important.
Authors: Aaron D Martin; Leah Y Nakamura; Rafael N Nunez; Christopher E Wolter; Mitchell R Humphreys; Erik P Castle Journal: J Urol Date: 2011-05-14 Impact factor: 7.450
Authors: Vincenzo Ficarra; Giacomo Novara; Raymond C Rosen; Walter Artibani; Peter R Carroll; Anthony Costello; Mani Menon; Francesco Montorsi; Vipul R Patel; Jens-Uwe Stolzenburg; Henk Van der Poel; Timothy G Wilson; Filiberto Zattoni; Alexandre Mottrie Journal: Eur Urol Date: 2012-06-01 Impact factor: 20.096
Authors: Robert K Nam; Patrick Cheung; Sender Herschorn; Refik Saskin; Jiandong Su; Laurence H Klotz; Michelle Chang; Girish S Kulkarni; Yuna Lee; Ronald T Kodama; Steven A Narod Journal: Lancet Oncol Date: 2014-01-17 Impact factor: 41.316