Radical Prostatectomy Survivorship: What Are We Really Asking?

Introduction Urinary incontinence, sexual dysfunction, and bowel dysfunction are well-recognized cancer survivorship outcomes affected by radical prostatectomy (RP) in the treatment of prostate cancer (PCa).The aim of this study was to audit the thoroughness of outpatient discussions and documentation of survivorship outcomes for patients who have undergone RP. Methods This was a retrospective audit of all 253 radical prostatectomies conducted at two tertiary-level Australian institutions (Monash Medical Centre and Alfred Hospital), over a five-year period between 2014 and 2018. Electronic medical records were reviewed across five time points: preoperative and then six weeks, three months, six months, and 12 months post-RP.The main outcomes measured were rates of documented discussions of urinary incontinence, sexual dysfunction, and bowel dysfunction. Results At the initial six-week postoperative review, there was an 86%, 47%, and 27% probability that urinary, sexual, and bowel functions were discussed and documented. When averaging across the four postoperative time points, from six weeks to 12 months, there was a 73%, 45%, and 14% respective rate of documented discussion for each survivorship outcome. Sexual and bowel function discussions were less frequently documented in men over 65 years of age compared with those under 65 years of age by 16% (p < 0.001) and 8% (p = 0.003), respectively. Conclusion Sexual and bowel dysfunction were less frequently discussed and documented in the follow-up of our cohort of RP patients compared with urinary continence outcomes.