The first 10 years’ experience in radical retropubic prostatectomy: complications, lower urinary tract symptoms, and quality of life – a single-center experience

Abstract

Introduction/Objective This 10-year prospective study’s primary objective was to evaluate the incidence of complications of radical retropubic prostatectomy (RRP). The secondary objective was to analyze how RRP affects lower urinary tract symptoms (LUTS) and quality of life (QoL) by using the International Prostate Symptom Score (IPSS).

Methods We analyzed 254 patients who underwent RRP in the period 2009–2018. All complications were graded according to the Clavien–Dindo classification. To assess urinary symptoms and the QoL, all the examinees filled out the IPSS and the International Prostate Symptom Score for QoL (IPSS QoL) questionnaires during preoperative preparation and three, six, and 12 months after surgery.

Results The incidence of complications Clavien–Dindo grade ≤ II and grade ≥ III were 26.4% and 16.5%, respectively. The mean overall IPSS for the entire group of patients after 12 months of follow-up was significantly different from the preoperative baseline value (p < 0.001). Patients with preoperative moderate (IPSS 8–19) and severe urinary symptoms (IPSS 20+) had a statistically significant reduction of urinary symptoms after RRP (p < 0.001). After 12 months, IPSS QoL was statistically significantly lower than the preoperative one (p < 0.05).

Conclusion For patients with clinically localized prostate cancer, RRP is a safe and effective treatment option. It is associated with a higher rate of complications from the Clavien–Dindo grade ≤ II group. RRP has clinically beneficial effects on LUTS in patients with moderate and severe urinary symptoms and the QoL related to LUTS.

Keywords: prostate cancer; radical prostatectomy; urination disorders; questionnaires