Biomedical subjects

Shunichi Namiki

Publications and source records attributed to Shunichi Namiki.

At least 19 recordsLinked to original sources

PubMed2006

Quality of life after brachytherapy or radical prostatectomy for localized prostate cancer: a prospective longitudinal study.

OBJECTIVES: To investigate health-related quality of life (HRQOL) in Japanese men with localized prostate cancer who underwent prostate brachytherapy (BT) or retropubic radical prostatectomy (RRP). METHODS: A total of 70 patients who underwent BT and 67 who underwent RRP were enrolled in our study. The Medical Outcomes Study 36-Item Short Form (SF-36), University of California, Los Angeles, Prostate Cancer Index, and the International Prostate Symptom Score were administered before and 1, 3, 6, and 12 months after treatment. No patients received neoadjuvant or adjuvant therapy. RESULTS: The RRP group reported significantly lower scores in several domains of the SF-36 at 1 month (P <0.05), but these domains returned to baseline within 6 months. The BT patients reported no significant changes in any of the general HRQOL domains throughout the follow-up period. The RRP group reported a lower posttreatment urinary function score, which reflected leakage, than the BT group. However, the BT patients experienced a significantly delayed recovery of the urinary bother score. The data from the International Prostate Symptom Score showed adverse effects from BT on voiding symptoms for the initial 6 months after treatment. No differences were found in bowel symptoms. RRP was associated with worse sexual function than BT, although nerve-sparing surgery minimized the difference. CONCLUSIONS: The results of this study have indicated that BT and RRP have meaningfully different profiles in the recovery of general QOL. The differences in the recovery of disease-specific HRQOL were pronounced during the first 12 months after treatment.

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PubMed2006

Natural history of voiding function after radical retropubic prostatectomy.

OBJECTIVES: To report results from a 2-year longitudinal survey of lower urinary tract function and quality of life (QOL) in men after radical retropubic prostatectomy (RP) for localized prostate cancer. METHODS: Between November 2001 and September 2003, self-report assessments were provided to 225 patients who underwent RP alone. The University of California Los Angeles Prostate Cancer Index (UCLA PCI), the International Prostate Symptom Score (IPSS), and the IPSS QOL score were administered before and 3, 6, 12, 18, and 24 months after RP. RESULTS: The overall mean total IPSS and IPSS QOL score progressively improved with time. The mean scores of several components improved significantly postoperatively. No significant difference was observed in nocturia between the baseline assessment and any of the postoperative follow-up assessments. The IPSS of the younger patients continued to recover significantly more rapidly than that of the older patients after RP. According to the UCLA PCI scores, urinary function substantially declined just after RP and continued to recover but scored lower than the baseline. The mean total IPSS and IPSS QOL scores observed in men with a UCLA PCI urinary function score of 80 or more were significantly better than in men with scores less than 80 at 24 months postoperatively. CONCLUSIONS: Radical retropubic prostatectomy has a significant beneficial effect on lower urinary tract symptoms. The rate of improvement was lowest for nocturia among the seven symptoms of IPSS. Urinary continence after RP and age can affect the recovery of voiding function.

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PubMed2006

Health-related quality of life after intensity modulated radiation therapy for localized prostate cancer: comparison with conventional and conformal radiotherapy.

OBJECTIVE: No previous studies have reported the longitudinal health-related quality of life (HRQOL) for intensity modulated radiation therapy (IMRT). We compared HRQOL after IMRT with that after conventional and after conformal radiation therapy (XRT). METHODS: A total of 110 patients underwent XRT (34 patients underwent conventional radiation therapy and 76 underwent conformal radiation therapy) and 30 underwent IMRT for clinically localized prostate cancer between 2000 and 2002. We measured the general and disease-specific HRQOL using the Medical Outcomes Study 36-Item Health Survey and University of California, Los Angeles, Prostate Cancer Index, respectively. RESULTS: There were no significant differences in the preoperative characteristics and HRQOL scores of the two groups. Repeated measure analyses of variance revealed significantly different patterns of alteration in several general HRQOL domains between XRT and the IMRT groups. In the urinary domain, there was no difference in the alteration patterns between the two groups. The XRT group suffered worse bowel function at 3 and 6 months than the IMRT group (P < 0.05). In the XRT group, sexual function decreased at 3 months and remained substantially lower than the baseline level. However, the IMRT group showed no significant difference from the baseline level at any of the observation periods. At 18 months the XRT group showed worse sexual function than the IMRT group. CONCLUSION: The two approaches showed different longitudinal profiles regarding general and disease-specific HRQOL during the first 2 years after treatment. The IMRT approach produced little impairment in bowel and sexual function.

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PubMed2006

Changes in quality of life in first year after radical prostatectomy by retropubic, laparoscopic, and perineal approach: Multi-institutional longitudinal study in Japan.

OBJECTIVES: To investigate the health-related quality of life of patients who underwent radical prostatectomy performed using retropubic, laparoscopic, and perineal approaches. METHODS: A total of 218 men who underwent retropubic prostatectomy, 65 who underwent laparoscopic prostatectomy, and 66 who underwent perineal prostatectomy were enrolled in our survey. A baseline interview was conducted before treatment. Follow-up interviews were conducted in person at scheduled study visits 1, 3, 6, and 12 months after surgery. We measured two validated questionnaires that assessed the general and disease-specific health-related quality of life. RESULTS: The retropubic group reported substantial deterioration in physical limitations, emotional limitations, social function, and bodily pain at 1 month. The perineal group reported less bodily pain just after surgery than the retropubic and laparoscopic groups. After 6 months, however, no significant differences were found among the three groups. Postoperative urinary function remained substantially lower than the baseline level in every treatment group. Each approach with a nerve-sparing procedure showed a similar recovery profile of urinary function postoperatively. The perineal group reported no significant difference in bowel function compared with the other two groups. All of the groups continued to have decrements in sexual function. CONCLUSIONS: The results of this study have demonstrated that retropubic, laparoscopic, and perineal prostatectomy have differences in the recovery of general and disease-specific quality of life in the early postoperative period. When performed by an experienced surgeon, the retropubic, laparoscopic, and perineal approaches appear to be equivalent in terms of health-related quality of life.

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PubMed2006

Relevance of postcatheter removal incontinence to postoperative urinary function after radical prostatectomy.

AIM: We examined whether postoperative urinary function after radical prostatectomy is associated with immediate incontinence just after catheter removal. PATIENTS AND METHODS: The current study included 80 patients with clinically localized prostate cancer, who underwent radical retropubic prostatectomy between January 2002 and May 2004. The amount of immediate incontinence was measured with a 24-h pad test just after catheter removal. The patients were categorized into the three groups based on the stratified grade of immediate urinary incontinence: groups I (0 g; 47 patients), II (1-99 g; 23 patients) and III (100 g and above; 10 patients), respectively. Urinary function and bother were assessed by a self-administered questionnaire using the University of California Los Angeles, Prostate Cancer Index at baseline, and at 3, 6 and 12 months postoperatively. The differences in scores of urinary function, bother and clinicopathological parameters were assessed in the three groups with one-way analysis of variance. RESULTS: No significant difference was observed in the clinicopathological parameters in the three groups. Preoperatively significant difference of urinary function scores was not evident and that of urinary bother scores was not observed in the three groups. Postoperatively urinary function scores were significantly different throughout the postoperative periods investigated, whereas difference in urinary bother scores observed at 3 months tended to disappear with time. CONCLUSION: Postcatheter removal incontinence might be related to postoperative urinary function after radical prostatectomy, although further investigation is necessary regarding the criteria for categorization because of a small number of the patients.

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PubMed2005

Intraoperative electrophysiological confirmation of neurovascular bundle preservation during radical prostatectomy: long-term assessment of urinary and sexual function.

OBJECTIVE: We investigated the longitudinal recovery of urinary and sexual function after radical retropubic prostatectomy (RP) using an intraoperative electrophysiological test to confirm the functional preservation of the neurovascular bundle (NVB). METHODS: A total of 70 patients who underwent RP for localized prostate cancer were prospectively enrolled in our survey. During RP, electrophysiological testing was performed to confirm the NVB preservation. The NVB was electrostimulated and the responses were observed by monitoring the intracavernous or intraurethral pressure changes. All patients were classified into three groups according to the degree of nerve-sparing [a bilateral nerve-sparing group (BNS), a unilateral nerve-sparing group (UNS) and a non-nerve-sparing group (NNS)] based on the macroanatomical as well as the electrophysiological assessment. Both urinary and sexual function were measured before and 3, 6, 12 and 24 months after RP by a self-administered questionnaire. RESULTS: The concordance rate of nerve-sparing or non-nerve-sparing between the electrophysiological and macroanatomical assessment was 80%. According to the electrophysiological data, the BNS maintained significantly better urinary function at 3 months after RP than the NNS and UNS. After 6 months, each group had almost recovered continence. When considering sexual function, the BNS showed better sexual function scores than the NNS throughout the post-operative periods and the UNS at 2 years. According to the macroanatomical assessment, however, these differences were significant. CONCLUSIONS: Nerve-sparing RP as confirmed by intraoperative electrophysiological test may contribute significantly to the early recovery of continence and greater rate of sexual function after RP.

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PubMed2005

Quality of life after radical prostatectomy in Japanese men: 2 year longitudinal study.

OBJECTIVE: We performed a 2 year longitudinal survey of health-related quality of life (HRQOL) after radical retropubic prostatectomy (RP) in Japanese men with localized prostate cancer. PATIENTS AND METHODS: We measured 112 patients who underwent RP with SF-36 and University of California, Los Angeles Prostate Cancer Index before and 3, 6, 12, 18 and 24 months after surgery. RESULTS: Patients who underwent RP showed problems in some domains of general HRQOL, but these problems diminished over time. Mental health significantly improved throughout the follow-up period. The urinary function substantially declined at 3 months and continued to recover gradually but never returned to the baseline. Urinary bother at 3 months showed a significant decrease, but at 6 months it returned to baseline. The data of sexual function and bother showed a substantially lower score after RP. Patients lost their sexual desire significantly throughout the post-operative period. After 12 months, the nerve sparing group had significantly better improvement in sexual function than the non-nerve sparing group and this improvement continued up to 2 years after operation. CONCLUSION: Despite reports of problems with sexuality and urinary continence, general HRQOL was mostly unaffected by RP after 6 months. RP had a favorable impact on mental health. Although urinary function did not completely return to the baseline level even at 2 years after RP, recovery from urinary bother was rapid. RP had serious consequences on libido, erectile function and sexual activity. In the second year, the sexual function of those who underwent RP with bilateral nerve sparing procedure continued to improve.

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PubMed2005

Recovery of quality of life in year after laparoscopic or retropubic radical prostatectomy: a multi-institutional longitudinal study.

OBJECTIVES: To compare the general and disease-specific health-related quality of life (HRQOL) after laparoscopic radical prostatectomy (LRP) with that after retropubic radical prostatectomy (RRP). METHODS: A total of 45 patients who underwent LRP alone and 121 who underwent RRP alone were prospectively enrolled in an HRQOL survey. We measured the general and disease-specific HRQOL with the Medical Outcomes Study 36-Item Short Form and University of California, Los Angeles, Prostate Cancer Index, respectively. The participants were asked to complete the questionnaires before and 1, 3, 6, and 12 months after surgery. RESULTS: No significant differences were found in the preoperative characteristics of the two groups. Repeated measures of analyses of variance revealed significantly different patterns of alteration in the several general HRQOL domains between the RRP and LRP groups. The LRP group tended to have a more delayed recovery than the RRP group in the domain of urinary function and bother. The sexual function and bother of both groups showed a substantially lower score throughout the postoperative period. When the LRP group was divided into two groups according to the surgical period, an apparent improvement in HRQOL was observed in the most recent LRP series. CONCLUSIONS: The two approaches showed different patterns of alteration regarding general HRQOL for 1 year after surgery. The LRP group reported delayed recovery of urinary and sexual function, which seemed to affect their general HRQOL. LRP appears to be still an evolving procedure.

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PubMed2005

Adverse effect of radical prostatectomy on nocturia and voiding frequency symptoms.

OBJECTIVES: To evaluate the impact of retropubic radical prostatectomy (RP) on urinary incontinence and obstructive/irritative urinary symptoms, according to global self-assessment instruments. METHODS: Self-report assessments were provided by 120 patients who underwent RP alone. The University of California, Los Angeles Prostate Cancer Index (UCLA PCI), the International Prostate Symptom Score (IPSS), and the IPSS quality of life (QOL) score were administered before and 12 months after RP. RESULTS: Overall mean total IPSS and IPSS QOL scores showed statistically significant improvement (both P < 0.001). There were no differences between baseline and postoperative scores in "Voiding frequency" or "Nocturia" related to irritative symptoms. Moreover, RP had adverse effects on the nocturia and voiding frequency composites score when the analysis was limited to those men who reported scores of 0 or 1 for each symptom preoperatively (P < 0.001 and P = 0.001, respectively). The urinary function score according to the UCLA PCI had substantially declined at 12 months compared with baseline (P < 0.001); however, no significant differences were observed in urinary bother between the baseline and postoperative scores. CONCLUSIONS: Although a significant proportion of men complained of urinary incontinence, RP significantly improved IPSS and IPSS QOL scores in men with moderate or severe urinary symptoms. However, RP seems to have a deleterious effect on nocturia and voiding frequency for some men with only mild symptoms.

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PubMed2005

Intraoperative electrophysiological confirmation of urinary continence after radical prostatectomy.

PURPOSE: To determine the actual effect of nerve sparing radical retropubic prostatectomy (RP) on postoperative urinary continence we used intraoperative electrophysiological testing to confirm functional preservation of the neurovascular bundle (NVB). MATERIALS AND METHODS: A total of 85 patients undergoing RP for localized prostate cancer were studied. During RP NVB preservation was assessed macroanatomically. Electrophysiological testing was then performed to confirm NVB preservation. The NVB was electrostimulated and responses were observed by monitoring intracavernous or intraurethral pressure changes. All patients were classified into 3 groups according to the degree of nerve sparing, that is a bilateral nerve sparing group, a unilateral nerve sparing group and a nonnerve sparing group, based on macroanatomical assessment as well as on electrophysiological assessment. Postoperative continence in each group was then determined. Urinary continence at baseline, and 3 and 6 months postoperatively was studied using a self-administered questionnaire. RESULTS: With electrophysiological assessment 20.6% of macroanatomically determined NVB preservations were reclassified. Analysis of the data on groups classified accurately by electrophysiological testing showed that the bilateral nerve sparing group maintained postoperative urinary function significantly more than the unilateral nerve sparing and nonnerve sparing groups. However, when only macroanatomical assessment was considered, no significant difference among the groups was found in urinary function. CONCLUSIONS: Electrophysiological assessment revealed that bilateral NVB preservation contributes to early recovery of urinary continence after RP. Thus, intraoperative electrophysiological assessment is useful for predicting postoperative quality of life.

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PubMed2005

Impact of hormonal therapy prior to radical prostatectomy on the recovery of quality of life.

BACKGROUND: We investigated the changes in health-related quality of life (HRQOL) in patients who underwent prostatectomy (RP) with or without neoadjuvant hormonal therapy (NHT). METHODS: A total of 72 patients undergoing direct RP (DRP group) and 26 patients receiving neoadjuvant hormonal therapy (NHT group) were enrolled in the present study. The baseline interview was conducted before RP (not initiation of therapy). Follow-up interviews were conducted in person at scheduled study visits of 3, 6, and 12 months after surgery. We measured general and disease specific HRQOL with the Medical Outcomes Study 36-Item Short Form and University of California, Los Angeles Prostate Cancer Index, respectively. RESULTS: At baseline, the NHT group scored statistically lower for not only sexual function (P < 0.001), but also the general HRQOL, such as role limitations due to physical problems (P = 0.007), social function (P = 0.045) and mental health (P = 0.034), than the DRP group. The NHT group reported lower scores in social function and mental health at 3 months (P = 0.040 and 0.006, respectively). Patients who received NHT for more than 3 months continued to show significantly lower scores for some HRQOL domains 12 months later. CONCLUSION: Neoadjuvant hormonal therapy may decrease not only sexual function, but also general HRQOL before surgery. The recovery of HRQOL appeared to be further prolonged in patients who received long-term NHT.

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PubMed2005

An evaluation of urinary function after radical prostatectomy in Japanese men: concordance with definitions of urinary continence.

OBJECTIVE: To determine how well various definitions of continence outcome after radical retropubic prostatectomy (RP) corresponded with each other, using published health-related quality-of-life (HRQoL) questionnaires. PATIENTS AND METHODS: In all, 198 patients undergoing RP alone were enrolled in a study between November 2000 and June 2003. The baseline interview was conducted before RP and 3, 6 and 12 months afterward. The disease-specific HRQoL was assessed using the University of California-Los Angeles Prostate Cancer Index; the correspondence among definitions of incontinence was investigated. RESULTS: The urinary function score substantially declined at 3 months, continued to recover at 6 and 12 months, but remained lower than at baseline (P < 0.001). The correspondence among definitions of continence varied widely; 97% of men who did not have urine leakage at all claimed to use no pads, but only 63% of those claiming no use of pads had no urine leakage at all. Interestingly, this concordance rate progressively changed from 46% at 3 months to 60% at 12 months, whereas it was 82% at baseline. CONCLUSIONS: Based on self-reported questionnaire data, different definitions of continence gave different results when applied to the same patients at the same time. The correspondence among definitions may vary with time after RP. No single question adequately assesses the urinary HRQoL outcome after treatment for prostate cancer.

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PubMed2005

[The Japanese translation and cultural adaptation of Expanded Prostate Cancer Index Composite (EPIC)].

PURPOSE: To develop a Japanese version of the Expanded Prostate Cancer Index Composite (EPIC): originally designed to measure the Quality of Life of localized prostate cancer patients, after careful assessments of cross-cultural equivalence, face validity and practically. METHODS: We translated the original version that consisted of 50 items into a preliminary Japanese version. This multi-stage procedure included a forward-translation, back-translation and discussion with the original developer. Additionally, we tested the preliminary Japanese version on 11 localized prostate cancer patients and identified problems with its cross-cultural equivalence, practicality. Based on the findings of this pretest, we revised the Japanese version. Consensus by discussion among all researchers was obtained through out this process. RESULTS: The original developer reviewed the back-translation of the preliminary Japanese version: some wording was revised. In the pretest, the average age of patients was 68.8 years old. Four of the sexual subscale showed over 10 percent missing data. In five items, all patients chose identical answers. We conducted an in-depth qualitative investigation of these items. The average response time was 11.7 minutes. We revised the Japanese to reflect patients' opinions as much as possible. Items which were showed problems in terms of cross-cultural adaptation included questions measuring 'bother' and two items of the sexual subscale. The wordings of these items were revised so that Japanese patients could easier understand them. We ensured that the original developer's intentions remained the same. The original developed approved all revisions. CONCLUSION: We translated and adapted the original EPIC to the Japanese culture. The Japanese version of EPIC was found to be functional in the pretest.

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PubMed2005

[Radical prostatectomy for localized prostate cancer].

With widespread use of PSA screening, radical prostatectomy has gained popularity among Japanese urologists over the last decade. Recent understanding of pelvic anatomy and improvement in surgical technique have substantially reduced its morbidity. Early recovery of urinary continence is possible and improvement of sexual function after surgery may be enhanced by use of sildenafil and nerve reconstructive surgery. As prostate cancer is increasingly diagnosed at early stages and therefore with more favorable survival outcomes, the basis on which patients select primary therapy has shifted toward considerations of health-related quality of life. Accordingly, QOL assessment has become an important form of outcomes based research that may weigh heavily on the treatment selection by patients.

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PubMed2004

Health related quality of life in Japanese men after radical prostatectomy or radiation therapy for localized prostate cancer.

BACKGROUND: We performed a retrospective survey of general and disease specific health-related quality of life (HRQOL) after radical prostatectomy (RP) and external beam radiotherapy (XRT) in Japanese men. METHODS: A total of 186 patients underwent RP and 78 underwent XRT for clinically localized prostate cancer between 2000 and 2002. We measured the general and disease specific HRQOL with the MOS 36-Item Health Survey and the University of California, Los Angeles Prostate Cancer Index, respectively. Each treatment group was further divided into four subgroups according to the time scale. RESULTS: Patients from the RP group were significantly younger than those from the XRT group. The tumor characteristics differed significantly in their distributions among the treatment groups. Patients undergoing XRT had low scores in most of the general measures of HRQOL just after treatment, but after 6 months there were no differences between the treatment groups, except for the physical domains. The RP group was associated with worse urinary function, whereas the XRT group had worse bowel function and bother during the first 6 months after treatment. Thereafter, however, urinary and bowel domain did not differ between the groups. Both groups reported poor sexual function, although the RP group scored lower sexual bother. CONCLUSION: The patients who underwent RP had significantly worse urinary and better bowel function than those treated with XRT. Both treatment groups had decrements in sexual function throughout the post-treatment period; careful attention should be paid to this side-effect in preoperative counselling, especially in younger patients, regardless of the primary treatments.

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PubMed2004

Recovery of health related quality of life after radical prostatectomy in japanese men: a longitudinal study.

BACKGROUND: We performed a longitudinal survey of health related quality of life (HRQOL) after radical retropubic prostatectomy (RP) in Japanese men with localized prostate cancer. METHODS: The present study started with self-reported HRQOL assessments provided by 72 patients who received only RP. The RAND 36-Item Health Survey and the University of California, Los Angeles Prostate Cancer Index were administered before and 3, 6 and 12 months after RP. RESULTS: Patients who underwent RP showed problems in some domains of general HRQOL, but these problems diminished over time. Urinary function declined substantially at 3 months and continued to recover at 6 and 12 months, but scored lower than the baseline. Urinary bother at 3 months had a significant decrease, but at six months it turned out to be the same as the baseline. The data of sexual function and bother showed a substantially lower score after RP. The sexual bother score of the younger men was significantly worse than that of the older men. Those who underwent nerve sparing procedures experienced significantly better recovery of urinary and sexual functions than the non-nerve sparing group. CONCLUSION: Despite reports of problems with sexuality and urinary continence, general HRQOL was mostly unaffected by RP after 6 months. Although there was a substantial decrease in urinary function, recovery from urinary bother was rapid. Deterioration of the sexual domain was remarkable throughout the postoperative period. Therefore, careful attention should be given to preoperative counseling, especially for younger patients.

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PubMed2004

[The perioperative charge equivalence of radical prostatectomy with 1-year follow up since the diagnosis of prostate cancer].

We assessed the 1-year charges in the group of patients undergoing radical prostatectomy and the changes in hospital costs and resource use following implementation of a clinical care path. A total of 69 consecutive men treated with radical prostatectomy for clinically localized prostate cancer were enrolled in the study. Hospital and outpatient records were analyzed for each patient in regard to preoperative, operative and postoperative charges of a 12-month period. Parameters included number of encounters, diagnostic and therapeutic interventions, hospitalization and operative charges, and follow-up visits, diagnostic tests and interventions for 1 year. The mean first-year cost of treatment with radical prostatectomy for localized prostate cancer was 144 x 10(4) yen. The increases in the first-year cost with higher prostate specific antigen (PSA) level for the diagnosis level appeared to primarily be associated with increased inpatient resource use and greater use of hormonal therapy. Length of the stay in a hospital significantly influenced the first-year cost. After implementation of the radical prostatectomy care path hospital costs decreased by 30% (66 x 10(4) yen vs 46 x 10(4) yen), total costs decreased 40% (190 x 10(4) yen vs 113 x 10(4) yen) and length of hospital stay decreased by 56% (37.0 vs 16.6). The first-year costs with radical prostatectomy are influenced greatly by the hormonal therapy and the number of hospital days. By standardizing preoperative and postoperative management for patients undergoing radical prostatectomy, significant savings can be achieved toward shorter hospital stays and lower hospital costs.

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PubMed2003

Health-related quality of life after radical prostatectomy in Japanese men with localized prostate cancer.

PURPOSE: We evaluated retrospectively health-related quality of life (HRQOL) after radical prostatectomy (RP) in Japanese men with localized prostate cancer. METHODS: The study was based on self-reported HRQOL of 280 patients. Patients were divided into seven groups: time 0 (T0), baseline before operation; T1, 1-3 months after RP; T2, 4-6 months after RP; T3, 7-12 months after RP; T4, 13-24 months after RP; T5, 25-36 months after RP; and T6, more than 36 months after RP. We measured the general and disease-specific HRQOL using the RAND 36-item Health Survey 1.0 (SF-36) and the University of California, Los Angeles Prostate Cancer Index (UCLA PCI). RESULTS: The general HRQOL of the postoperative groups was assessed by SF-36. The postoperative groups showed almost the same or higher scores than those of the baseline group. Urinary function scores decreased substantially after surgery. In contrast, there was no difference in urinary bother between the baseline and postoperative groups. Sexual function deteriorated substantially in all postoperative groups. Similarly, the sexual bother score significantly deteriorated after RP. The sexual bother score of men aged 65-years or younger was significantly worse than that of their counterparts in the T1-2 groups. CONCLUSION: Despite reports of problems with sexual activity and urinary continence, general HRQOL was mostly unaffected by RP. Although there was a substantial decrease in urinary function, recovery from urinary bother was rapid. Since the deterioration of sexual function was marked through the postoperative period, careful attention should be paid to this issue during preoperative counseling, especially for younger patients.

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