Reviewing the changes in quality of life and lower urinary tract symptoms in patients with prostate cancer following prostate surgery

This review explained the changes in lower urinary tract symptoms (LUTS) and quality of life (QoL) that occurred over time in patients with prostate cancer following radical prostatectomy (RP; removal of the prostate). The data showed that 6 to 12 months are required for LUTS improvement after RT.

Patients with prostate cancer (PCa) treated with RP often experience LUTS that affect their ability to retain and excrete urine. Urinary incontinence (UI; urine leakage) is the most frequently reported LUTS. But other symptoms can occur such as urinary retention and involuntary bladder contraction (overactive bladder). 

LUTS affect the quality of life (QoL) of patients after discharge following the procedure. Social activities are affected, and emotional and psychological effects occur in patients. It is therefore important to keep patients informed of the expected changes in LUTS and QoL to facilitate self-management.

This review analyzed 14 studies on patients with PCa who had LUTS after RP. LUTS were categorized as storage symptoms (waking up at night to urinate or nocturia), urinating more frequently during the daytime and urgency), voiding symptoms (intermittency, having a slow stream, and straining while urinating), and symptoms that occurred after urination (incomplete emptying). Changes in LUTS were evaluated using the International Prostate Symptom Score (IPSS). Improvements in QoL were monitored using the IPSS-QoL Score. Patients were followed for up to 12 months.

Patients had increased urine frequency, night-time frequency, and urgency, at 3 months after surgery. IPSS was significantly improved at 6 months and 12 months. At 12 months after surgery, IPSS-QoL was significantly improved. Lower patient age (below 65), lower prostate volume (below 50ml), and lower IPSS before surgery were related to improvements after surgery.

The study showed that 6 months to 12 months are needed for a significant decrease in LUTS after RP and that LUTS severity was associated with QoL.

The review included studies that were not randomized and lacked controls, making it difficult to draw definitive conclusions.