Satisfaction and regret after radical prostatectomy procedures studied

New study published in European Urology

Amsterdam, 26 August 2008 - Studies have shown that approximately 16% of patients with localised prostate cancer regret their treatment choice. European Urology, the official journal of the European Association of Urology, will be publishing an article by J.W. Moul et al. comparing differences in satisfaction and regret between patients who underwent open retropubic radical prostatectomy and robot-assisted laparoscopic radical prostatectomy.

The study, carried out at the Duke University Medical Center, Durham (US), aimed to identify independent predictors for satisfaction and regret after radical prostatectomy so that patients can be counselled more adequately. A total of 400 patients responded, the majority of whom were satisfied. The article title is ‘Satisfaction and regret after open retropubic or robot-assisted laparoscopic radical prostatectomy’.

This is the first study addressing the impact of a surgical approach to prostatectomy on satisfaction and regret. Sociodemographic variables and disease-specific, health-related quality of life were important variables associated with satisfaction and regret. The authors found that undergoing robot-assisted laparoscopic radical prostatectomy (RALP) is independently associated with more frequent dissatisfaction and regret, about 3-4 times more than patients undergoing retropubic radical prostatectomy (RRP).

The authors state that patients who chose the innovative, less invasive RALP may have higher expectations for their postoperative health-related quality of life compared to patients choosing more traditional surgery. Therefore, even if both groups achieved similar function and bother scores, the RALP group still experienced a higher level of dissatisfaction and regret than the RRP group.

African-American race was significantly associated with regret. This may be caused by a possible broad black-white perception gap in health care. It may also be caused by the fact that patients tend to give higher ratings of satisfaction to race-concordant physicians and none of the physicians in the study were African American. Further research in more diverse patient populations is needed.

Also of interest is the finding that longer follow-up was independently associated with satisfaction and regret, i.e. patients tend to regret their treatment choice more if poor health-related quality of life persists over a longer period of time.

The authors suggest that urologists carefully portray the risks and benefits of new technologies during preoperative counselling to minimise regret and maximise satisfaction.

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About the European Association of Urology (EAU)
The European Association of Urology (EAU) represents more than 16,000 urology professionals across Europe and worldwide. Its mission is to raise the level of urological care in Europe.
The EAU is headed by an Executive Committee (EC) and the chairmen of the EAU offices. Together they form the EAU Board. The EC is chaired by the Secretary-General who is responsible, together with the other members of the EC, for the implementation of all programmes and activities decided by the Board.
The EAU Annual Congress is the second largest urological congress in the world.
Education and postgraduate training are essential tasks of the EAU and aims at promoting quality urological education across Europe and worldwide.
Providing effective communication links to promote and disseminate scientific results and information amongst European urologists through e.g. European Urology and European Urology Today remains vital.
Finally, the EAU has special sections on the Internet, such as Uroweb and Urosource, which allows for direct communication between members.

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