Improvement of quality of life and symptom burden after robot-assisted radical prostatectomy in patients with moderate to severe LUTS

Abstract The aim of this study was to assess clinically meaningful differences of preoperative lower urinary tract symptoms (LUTS) and quality of life (QoL) before and after robot-assisted radical prostatectomy (RARP). Therefore we identified 5506 RARP patients from 2007 to 2018 with completed Inter...

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Autores principales:	Sami-Ramzi Leyh-Bannurah, Christian Wagner, Andreas Schuette, Nikolaos Liakos, Theodoros Karagiotis, Mikolaj Mendrek, Pawel Rachubinski, Katarina Urbanova, Matthias Oelke, Jorn H. Witt
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/697d47fb7aa84ff890e26cbed7bb32d9
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spelling	oai:doaj.org-article:697d47fb7aa84ff890e26cbed7bb32d92021-12-02T16:45:46ZImprovement of quality of life and symptom burden after robot-assisted radical prostatectomy in patients with moderate to severe LUTS10.1038/s41598-021-95525-22045-2322https://doaj.org/article/697d47fb7aa84ff890e26cbed7bb32d92021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-95525-2https://doaj.org/toc/2045-2322Abstract The aim of this study was to assess clinically meaningful differences of preoperative lower urinary tract symptoms (LUTS) and quality of life (QoL) before and after robot-assisted radical prostatectomy (RARP). Therefore we identified 5506 RARP patients from 2007 to 2018 with completed International Prostate Symptom Score (IPSS) and -QoL questionnaires before and 12 months after RARP in our institution. Marked clinically important difference (MCID) was defined by using the strictest IPSS-difference of − 8 points. Multivariable logistic regression analyses (LRM) aimed to predict ∆IPSS ≤ − 8 and were restricted to RARP patients with preoperatively moderate (IPSS 8–19) vs. severe (IPSS 20–35) LUTS burden (n = 2305). Preoperative LUTS was categorized as moderate and severe in 37% (n = 2014) and 5.3% of the complete cohort (n = 291), respectively. Here, a postoperative ∆IPSS ≤ − 8, was reported in 38% vs. 90%. In LRM, younger age (OR 0.98, 95%CI 0.97–0.99; p = 0.007), lower BMI (OR 0.94, 95%CI 0.92–0.97; p < 0.001), higher preoperative LUTS burden (severe vs. moderate [REF.] OR 15.6, 95%CI 10.4–23.4; p < 0.001), greater prostate specimen weight (per 10 g, OR 1.12, 95%CI 1.07–1.16; p < 0.001) and the event of urinary continence recovery (OR 1.66 95%CI 1.25–2.21; p < 0.001) were independent predictors of a marked LUTS improvement after RARP. Less rigorous IPSS-difference of − 5 points yielded identical predictors. To sum up, in substantial proportions of patients with preoperative moderate or severe LUTS a marked improvement of LUTS and QoL can be expected at 12 months after RARP. LRM revealed greatest benefit in those patients with preoperatively greatest LUTS burden, prostate enlargement, lower BMI, younger age and the event of urinary continence recovery.Sami-Ramzi Leyh-BannurahChristian WagnerAndreas SchuetteNikolaos LiakosTheodoros KaragiotisMikolaj MendrekPawel RachubinskiKatarina UrbanovaMatthias OelkeJorn H. WittNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sami-Ramzi Leyh-Bannurah Christian Wagner Andreas Schuette Nikolaos Liakos Theodoros Karagiotis Mikolaj Mendrek Pawel Rachubinski Katarina Urbanova Matthias Oelke Jorn H. Witt Improvement of quality of life and symptom burden after robot-assisted radical prostatectomy in patients with moderate to severe LUTS
description	Abstract The aim of this study was to assess clinically meaningful differences of preoperative lower urinary tract symptoms (LUTS) and quality of life (QoL) before and after robot-assisted radical prostatectomy (RARP). Therefore we identified 5506 RARP patients from 2007 to 2018 with completed International Prostate Symptom Score (IPSS) and -QoL questionnaires before and 12 months after RARP in our institution. Marked clinically important difference (MCID) was defined by using the strictest IPSS-difference of − 8 points. Multivariable logistic regression analyses (LRM) aimed to predict ∆IPSS ≤ − 8 and were restricted to RARP patients with preoperatively moderate (IPSS 8–19) vs. severe (IPSS 20–35) LUTS burden (n = 2305). Preoperative LUTS was categorized as moderate and severe in 37% (n = 2014) and 5.3% of the complete cohort (n = 291), respectively. Here, a postoperative ∆IPSS ≤ − 8, was reported in 38% vs. 90%. In LRM, younger age (OR 0.98, 95%CI 0.97–0.99; p = 0.007), lower BMI (OR 0.94, 95%CI 0.92–0.97; p < 0.001), higher preoperative LUTS burden (severe vs. moderate [REF.] OR 15.6, 95%CI 10.4–23.4; p < 0.001), greater prostate specimen weight (per 10 g, OR 1.12, 95%CI 1.07–1.16; p < 0.001) and the event of urinary continence recovery (OR 1.66 95%CI 1.25–2.21; p < 0.001) were independent predictors of a marked LUTS improvement after RARP. Less rigorous IPSS-difference of − 5 points yielded identical predictors. To sum up, in substantial proportions of patients with preoperative moderate or severe LUTS a marked improvement of LUTS and QoL can be expected at 12 months after RARP. LRM revealed greatest benefit in those patients with preoperatively greatest LUTS burden, prostate enlargement, lower BMI, younger age and the event of urinary continence recovery.
format	article
author	Sami-Ramzi Leyh-Bannurah Christian Wagner Andreas Schuette Nikolaos Liakos Theodoros Karagiotis Mikolaj Mendrek Pawel Rachubinski Katarina Urbanova Matthias Oelke Jorn H. Witt
author_facet	Sami-Ramzi Leyh-Bannurah Christian Wagner Andreas Schuette Nikolaos Liakos Theodoros Karagiotis Mikolaj Mendrek Pawel Rachubinski Katarina Urbanova Matthias Oelke Jorn H. Witt
author_sort	Sami-Ramzi Leyh-Bannurah
title	Improvement of quality of life and symptom burden after robot-assisted radical prostatectomy in patients with moderate to severe LUTS
title_short	Improvement of quality of life and symptom burden after robot-assisted radical prostatectomy in patients with moderate to severe LUTS
title_full	Improvement of quality of life and symptom burden after robot-assisted radical prostatectomy in patients with moderate to severe LUTS
title_fullStr	Improvement of quality of life and symptom burden after robot-assisted radical prostatectomy in patients with moderate to severe LUTS
title_full_unstemmed	Improvement of quality of life and symptom burden after robot-assisted radical prostatectomy in patients with moderate to severe LUTS
title_sort	improvement of quality of life and symptom burden after robot-assisted radical prostatectomy in patients with moderate to severe luts
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/697d47fb7aa84ff890e26cbed7bb32d9
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Improvement of quality of life and symptom burden after robot-assisted radical prostatectomy in patients with moderate to severe LUTS

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