Examining the role of pre-operative expectations on patient-reported quality of life, following robotic-assisted radical prostatectomy: prelimary analysis of baseline data.

Abstract

OBJECTIVE: Patient expectations for recovery following robot-assisted radical prostatectomy (RARP) may influence adjustment following treatment. There is little data regarding the treatment expectations of Australian RARP patients. This study aimed to assess the difference between patient-reported pre-operative sexual and urinary function, and expected functioning at 12 months post-RARP. METHODS: Patients undergoing RARP for localised prostate cancer were recruited from urology practices between June 2015 and April 2016 as part of an ongoing study. Pre-operative sexual and urinary function and expected functioning at 12 months post-RARP were measure using the Expanded Prostate Index Composite (EPIC)-26 and EPIC-26 (Expectations). Paired samples t-tests were used to assess the difference between pre-operative and expected function at 12 months post-surgery. RESULTS: Seventy-four patients completed questionnaires at baseline. Compared to pre-operative functioning, 35%, 27% and 63% of patients expected worse Urinary Incontinence (UI), Urinary Irritative/Obstructive (UQ) and Sexual (S) function respectively, at 12 months post-RARP. Conversely 12%, 15% and 10% of patients expected better UI, UQ and S function compared to preoperative function. As many as 53%, 58% and 27% of patients expected UI, UQ and S function respectively to recover to baseline levels at 12 months post-RARP. Patients expected worse UI (p=0.003), UQ (p=0.038) and S functions (p<0.001) at 12 months post-RARP compared to preoperative functioning. CONCLUSION: The majority of men believed that their urinary and sexual function at 12 months post-surgery would be unchanged or worse compared to preoperative levels. Understanding RARP patients' expectations may assist in development of supportive care interventions to ensure realistic expectations or quality of life post-surgery.