Assessment of Urinary and Sexual Quality of Life Using the Expanded Prostate Cancer Index Composite in Patients Undergoing Minimum Incision Endoscopic Radical Prostatectomy with Intentional Wide Resection

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Objectives: The aim of this study was to evaluate the effects of minimum incision endoscopic radical prostatectomy with intentional wide resection on urinary and sexual QOL in patients with prostate cancer.

Methods: We enrolled 101 patients, 72 in the minimum incision endoscopic radical prostatectomy group and 29 in the laparoscopic radical prostatectomy group as control. QOL was assessed using the Expanded Prostate Cancer Index Composite questionnaire. The evaluation items consisted of: urinary function, urinary bother, sexual function, sexual bother, pad-free rate, and satisfaction. Questionnaires were administered once preoperatively and six times postoperatively. In addition, we analyzed factors other than surgical technique that affected QOL.

Results: There was no significant difference in urinary domain scores between the two groups. pad-free rate was higher in the minimum incision endoscopic radical prostatectomy group. Sexual function scores showed a significant decrease at 4 weeks postoperatively in both groups and did not improve thereafter; however, no significant difference was finally found between the groups. There was no significant decrease in sexual bother score and satisfaction postoperatively, and there was no significant difference between the groups. Age influenced the preoperatively sexual function score. Although there was no significant difference between the groups at any time point, the younger group consistently had a lower sexual bother score.

Conclusion: Minimum incision endoscopic radical prostatectomy did not significantly decrease QOL compared with laparoscopic radical prostatectomy. Age had a greater impact on QOL than surgical technique. Sexual dysfunction should be taken into consideration, especially when treating younger patients.