Document Detail

Demonstration of erectile management techniques to men scheduled for radical prostatectomy reduces long-term regret: a comparative cohort study.
MedLine Citation:
PMID:  21883815     Owner:  NLM     Status:  MEDLINE    
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.
Janette Kinsella; Peter Acher; Anna Ashfield; Kathryn Chatterton; Prokar Dasgupta; Declan Cahill; Rick Popert; Tim O'Brien
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2011-08-25
Journal Detail:
Title:  BJU international     Volume:  109     ISSN:  1464-410X     ISO Abbreviation:  BJU Int.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-03     Completed Date:  2012-02-21     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  254-8     Citation Subset:  IM    
Copyright Information:
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MeSH Terms
Cohort Studies
Decision Making*
Erectile Dysfunction / etiology,  psychology*,  therapy*
Follow-Up Studies
Middle Aged
Patient Education as Topic
Patient Satisfaction*
Preoperative Care
Prospective Studies
Prostatectomy / adverse effects,  psychology*
Prostatic Neoplasms / psychology,  surgery*
Treatment Outcome
Grant Support
G0600698//Medical Research Council
Comment In:
J Urol. 2012 Oct;188(4):1268-9   [PMID:  22971399 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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