Scholarlink

Introduction and aim <p>Prostate cancer (PCa) remains the most common non-cutaneous cancer among men in Europe, with treatment advances improving mortality outcomes. Radical prostatectomy (RP) is a key treatment option for localized PCa, anyway complications such as urinary incontinence and erectile dysfunction can influence patient satisfaction and decision regret.</p> <p>This multicenter study aims to identify factors that can assist urologists in improving preoperative counseling through levels of satisfaction or regret, with the goal of increasing patient awareness regarding the potential risks and complications associated with RP<b>.</b></p> Materials and methods <p>A prospective analysis was conducted on 590 patients undergoing RP across 4 Italian centers (from 2019 to 2022). Decision regret was assessed using the validated Decision Regret Scale (DRS). The mean score of the five items of the DRS was calculated and then converted to a 100-points scale, with a cutoff score of 25 distinguishing low from high regret. Logistic regression analysis evaluated predictors of treatment regret.</p> Results <p>At a median follow-up of 23&#xa0;months, 79% of patients reported low decision regret (DRS ≤ 25). Lower decision regret was associated with lower rates of urinary incontinence and erectile dysfunction. Multivariate analysis identified urinary continence (OR 3.8, <i>p</i> &lt; 0.001), erectile function (OR 0.3, <i>p</i> &lt; 0.001), and robotic surgery (OR 3.7, <i>p</i> = 0.009) as significant independent predictors of satisfaction. In addition, poorer quality of life correlated with increased regret.</p> Conclusion <p>Our study emphasizes the importance of evaluating surgical outcomes to predict patient satisfaction, optimizing preoperative counseling, and reducing long-term regret. Urinary and sexual function, and surgical technique influence satisfaction and quality of life. Further research should explore patient-specific predictors and optimize timing for outcome evaluations.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Patient satisfaction and decision regret in patients undergoing radical prostatectomy: a multicenter analysis

  • 期刊论文

  • 发表日期：

    2025年4月17日

查看全文
  • Alessandro Guercio,
  • Riccardo Lombardo,
  • Beatrice Turchi,
  • Matteo Romagnoli,
  • Antonio Franco,
  • Simone D’Annunzio,
  • Ferdinando Fusco,
  • Antonio Luigi Pastore,
  • Yazan Al Salhi,
  • Andrea Fuschi,
  • Antonio Cicione,
  • Giorgia Tema,
  • Antonio Nacchia,
  • Antonio Carbone,
  • Giuseppe Simone,
  • Cristian Fiori,
  • Giovanni Busacca,
  • Francesco Porpiglia,
  • Marcello Scarcia,
  • Andrea Tubaro,
  • Cosimo De Nunzio

摘要

Introduction and aim

Prostate cancer (PCa) remains the most common non-cutaneous cancer among men in Europe, with treatment advances improving mortality outcomes. Radical prostatectomy (RP) is a key treatment option for localized PCa, anyway complications such as urinary incontinence and erectile dysfunction can influence patient satisfaction and decision regret.

This multicenter study aims to identify factors that can assist urologists in improving preoperative counseling through levels of satisfaction or regret, with the goal of increasing patient awareness regarding the potential risks and complications associated with RP.

Materials and methods

A prospective analysis was conducted on 590 patients undergoing RP across 4 Italian centers (from 2019 to 2022). Decision regret was assessed using the validated Decision Regret Scale (DRS). The mean score of the five items of the DRS was calculated and then converted to a 100-points scale, with a cutoff score of 25 distinguishing low from high regret. Logistic regression analysis evaluated predictors of treatment regret.

Results

At a median follow-up of 23 months, 79% of patients reported low decision regret (DRS ≤ 25). Lower decision regret was associated with lower rates of urinary incontinence and erectile dysfunction. Multivariate analysis identified urinary continence (OR 3.8, p < 0.001), erectile function (OR 0.3, p < 0.001), and robotic surgery (OR 3.7, p = 0.009) as significant independent predictors of satisfaction. In addition, poorer quality of life correlated with increased regret.

Conclusion

Our study emphasizes the importance of evaluating surgical outcomes to predict patient satisfaction, optimizing preoperative counseling, and reducing long-term regret. Urinary and sexual function, and surgical technique influence satisfaction and quality of life. Further research should explore patient-specific predictors and optimize timing for outcome evaluations.