Some men who undergo surgery for prostate cancer expect better recovery of sexual and urinary functions than they actually experience. These findings were recently published in the Journal of Urology.

For men who undergo radical prostatectomy (complete removal of the prostate), side effects may include urinary incontinence (leakage of urine) and erectile dysfunction. These complications can have a profound effect on quality of life. Many patients are counseled on the potential side effects of prostate surgery, but they still may not have realistic expectations about their personal outcomes.

To learn more about how men undergoing surgery for prostate cancer expect to recover, researchers followed 152 men who underwent radical prostatectomy. Participants received extensive counseling before surgery about what to expect following the procedure. At the start of the study, patients reported their expectations for functions including urinary and sexual function. These expectations were compared with the men’s actual status one year after surgery.

  • Prior to surgery, 12% of men expected urinary incontinence to improve with surgery and 17% expected sexual function to improve; this is the opposite of what typically happens with surgery.
  • At one year after surgery, 46% of the men had worse urinary incontinence than they had expected and 44% had worse sexual function than they had expected.

These findings suggest that some men who undergo radical prostatectomy don’t have realistic expectations for urinary and sexual outcomes, even when they are counseled about potential side effects before surgery. The researchers suggest that given that expected outcomes aren’t always realized, prostate cancer patients may benefit from additional support to help them cope with urinary and sexual complications.

Reference: Wittmann D, He C, Coelho M, et al. Patient preoperative expectations of urinary, bowel, hormonal and sexual functioning do not match actual outcomes 1 year after radical prostatectomy. Journal of Urology. Volume 186, Issue 2, Pages 494-499, August 2011.

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