PATIENT-REPORTED COMPLICATIONS AND FOLLOW-UP TREATMENT AFTER RADICAL PROSTATECTOMY - THE NATIONAL MEDICARE EXPERIENCE - 1988-1990 (UPDATED JUNE 1993)
PATIENT-REPORTED COMPLICATIONS AND FOLLOW-UP TREATMENT AFTER RADICAL PROSTATECTOMY - THE NATIONAL MEDICARE EXPERIENCE - 1988-1990 (UPDATED JUNE 1993)
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DOI：
10.1016/0090-4295(93)90524-e
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发表时间：
1993-12-01
期刊：
影响因子：
2.1
通讯作者：
WENNBERG, JE
中科院分区：
文献类型：
--
作者：
FOWLER, FJ;BARRY, MJ;WENNBERG, JE
为了估计并发症和后续治疗的可能性，通过邮件、电话和个人访谈对接受根治性前列腺切除术（1988 年至 1990 年）的 Medicare 患者样本进行了调查。受访者报告了他们目前在节制和性功能方面的状况，以及他们为治疗残留或复发性癌症或手术并发症而必须进行的术后治疗。超过 30% 的人表示目前佩戴护垫或夹子来应对潮湿；超过 40% 的人表示，他们在咳嗽或膀胱充盈时会漏尿； 23% 的受访者表示每天的润湿量超过几滴。大约 60% 的患者表示自手术后没有完全或部分勃起，只有 11% 的患者在调查前一个月内有足以进行性交的勃起。百分之六的人在根治性前列腺切除术后接受手术治疗失禁； 15% 的人接受过治疗或使用设备来帮助改善性功能； 20% 的人表示曾接受过尿道狭窄的术后治疗。此外，16%、22% 和 28% 的受访者报告在根治性前列腺切除术后两年、三年和四年后进行了癌症后续治疗（放射或雄激素剥夺疗法）。与之前发布的估计相比，这些并发症和后续治疗率的估计通常更高，而且几乎肯定更能代表老年男性。在考虑对前列腺癌进行根治性前列腺切除术时，患者和医生可能需要认真权衡并发症和后续治疗的需要。
To estimate the probabilities of complications and follow-up treatment, a sample of Medicare patients who underwent radical prostatectomy (1988 through 1990) was surveyed by mail, telephone, and personal interview. Respondents reported their current status with respect to continence and sexual function as well as post-surgical treatments they had had to treat residual or recurrent cancer or surgical complications. Over 30 percent reported currently wearing pads or clamps to deal with wetness; over 40 percent said they drip urine when they cough or when their bladders are full; 23 percent reported daily wetting of more than a few drops. About 60 percent of patients reported having no full or partial erections since their surgery, and only 11 percent had any erections sufficient for intercourse during the month prior to the survey. Six percent had surgery after the radical prostatectomy to treat incontinence; 15 percent had treatments or used devices to help with sexual function; 20 percent report having had post-surgical treatment for urethral strictures. In addition 16 percent, 22 percent, and 28 percent reported follow-up treatment for cancer (radiation or androgen deprivation therapy) at two, three, and four years after radical prostatectomy. These estimates of complication and follow-up treatment rates are generally higher, and almost certainly more representative for older men, than estimates previously published. Patients and physicians may want to weigh heavily the complications and need for follow-up treatments when considering radical prostatectomy for prostate cancer.