Predictive factors of regret, dissatisfaction after prostatectomy reported

Regret and dissatisfaction after prostatectomy may depend on certain sociodemographic variables and quality of life, as well as the type of prostatectomy performed, according to recent data.

Researchers from the Duke University Medical Center in North Carolina conducted a cross-sectional analysis that included 400 men who underwent retropubic radical prostatectomy or robot-assisted laparoscopic radical prostatectomy between 2000 and 2007. Participants responded to a mailed questionnaire regarding sociodemographic factors and the satisfaction and regret of their chosen treatment.

Eighty-four percent reported satisfaction with their decisions, and 19% regretted their treatment choice.

In a multivariate analysis, satisfaction was associated with lower income (OR=0.08; 95% CI, 0.03-0.23), shorter follow-up (OR=0.63; 95% CI, 0.41-0.98), having chosen retropubic radical prostatectomy over robot-assisted laparoscopic radical prostatectomy (OR=4.45; 95% CI, 1.90-10.4), urinary domain scores (OR=2.70; 95% CI, 1.60-4.54) and hormonal domain scores (OR=2.01; 95% CI, 1.30-3.12; P<.039 for all).

Predictive factors of regret included years since surgery (OR=1.63; 95% CI, 1.13-2.36), hormonal domain scores (OR=0.67; 95% CI, 0.45-0.98), lower urinary domain scores (OR=0.58; 95% CI, 0.37-0.91) and robot-assisted laparoscopic radical prostatectomy vs. retropubic radical prostatectomy (OR=3.02; 95% CI, 1.50-6.07; P<.041 for all).

The researchers suggested patients be told of treatment-associated risks and benefits prior to procedures to avoid regret and dissatisfaction.

Eur Urol. 2008;doi:10.1016/j.eurouro.2008.06.063