| Demonstration of erectile management techniques to men scheduled for radical prostatectomy reduces long-term regret: a comparative cohort study. | |
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MedLine Citation:
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PMID: 21883815 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine whether preoperative demonstrations of intracavernosal and vacuum therapies for erectile dysfunction (ED) influence the decision of treatment choice, reducing long-term regret. PATIENTS AND METHODS: In all, 82 consecutive men with localized prostate cancer, scheduled for radical prostatectomy and reporting an International Index of Erectile Function score of >21, were prospectively enrolled at a single cancer centre. Following standard preoperative counselling, half of the men were invited to attend a further consultation for intracavernosal and vacuum therapy demonstrations. All patients were evaluated pretreatment and then 3 monthly using the five-point International Index of Erectile Function score and the 14-item Hospital Anxiety and Depression scale. At 12 months treatment choice changes were recorded and patients were assessed for treatment choice regret using Clark's validated two-item regret questionnaire. Statistical analysis was performed using the Mann-Whitney and Fisher's exact tests. Results were compared with a control population of 41 men who did not undergo additional ED counselling. RESULTS: In all, 8/41 men (19%) changed their treatment choice, opting for brachytherapy rather than radical prostatectomy. Only 1/41 in the control population changed their decision before surgery. At 1 year, one patient (2%) in the intervention group expressed regret at his treatment choice (radical prostatectomy) compared with eight (20%) in the control group (P= 0.03, two-sided Fisher's exact test); ED was identified as the major cause of this regret. CONCLUSION: Preoperative demonstrations of ED therapies can optimize decision making in prostate cancer and help reduce long-term regret. |
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Authors:
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Janette Kinsella; Peter Acher; Anna Ashfield; Kathryn Chatterton; Prokar Dasgupta; Declan Cahill; Rick Popert; Tim O'Brien |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2011-08-25 |
Journal Detail:
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Title: BJU international Volume: 109 ISSN: 1464-410X ISO Abbreviation: BJU Int. Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-01-03 Completed Date: 2012-02-21 Revised Date: 2012-11-06 |
Medline Journal Info:
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Nlm Unique ID: 100886721 Medline TA: BJU Int Country: England |
Other Details:
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Languages: eng Pagination: 254-8 Citation Subset: IM |
Copyright Information:
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© 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL. |
Affiliation:
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Urology Centre, Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, Great Maze Pond, London, UK. Janette.Kinsella@gstt.nhs.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cohort Studies Decision Making* Emotions Erectile Dysfunction / etiology, psychology*, therapy* Follow-Up Studies Humans Male Middle Aged Patient Education as Topic Patient Satisfaction* Preoperative Care Prospective Studies Prostatectomy / adverse effects, psychology* Prostatic Neoplasms / psychology, surgery* Treatment Outcome |
| Comments/Corrections | |
Comment In:
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J Urol. 2012 Oct;188(4):1268-9
[PMID:
22971399
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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