Outcomes in Health-Related Quality of Life and Impact of Urinary Incontinence on Health-Related Quality of Life 7 Years After Robot-Assisted Radical Prostatectomy.

Objective: We evaluated the long-term outcomes in health-related quality of life (QOL) after robot-assisted radical prostatectomy (RARP) and the factors influencing them.

Methods: Overall, 246 patients who underwent RARP were included. The Expanded Prostate Cancer Index Composite (EPIC) and Short Form-8 (SF-8) questionnaires were utilized. Continence was defined as a score of ≤ 1 on question 1 of the International Consultation on Incontinence Questionnaire-Short Form. Questionnaires were collected preoperatively until 84 months postoperatively. For EPIC, each score was compared to preoperative values to examine the changes in HRQOL. For SF-8, the change in each score was examined separately for groups with and without urinary incontinence. Furthermore, factors influencing the SF-8 scores at 60 and 84 months postoperatively were analyzed.

Results: In EPIC urinary function, urinary incontinence, and sexual function scores decreased significantly beginning from 1 month postoperatively and did not return to preoperative levels even after 84 months. In SF-8, social function, mental health, and mental health summary scores were significantly lower postoperatively in those with urinary incontinence. Multivariate analysis showed that urinary incontinence was a significant factor that affected the SF-8 scores at 60 and 84 months postoperatively (p = 0.003 and p = 0.039, respectively).

Conclusions: The QOL related to urinary and sexual function showed a sustained decline up to 84 months postoperatively compared to preoperative levels. Urinary incontinence was a significant predictor of HRQOL at 60 and 84 months postoperatively.