Satisfaction and regret after two types of radical prostatectomy

Schroek et al. have published a complete report on  variables influencing satisfaction and regret following open radical retropubic prostatectomy (RRP) and robot-assisted laparoscopic prostatectomy (RALP). Their primary goal was to identify independent predictors for patient satisfaction and regret after surgical treatment.

Patients who had undergone RRP or RALP between 2000 and 2007 were surveyed, and 400 patients (61 percent of those surveyed) provided usable reponses to questionnaires.

The results provided by the authors were as follows:

• 84 percent of patients were satisfied and 19 percent regretted their treatment choice.
• Among patients who were satisfied, the following were independently predictive of satisfaction:
  • Lower income
  • Shorter follow-up
  • Having undergone RRP versus RALP
  • Urinary domain scores and
  • Hormonal domain scores
• Among the patients who regretted their decision, the following were independently predictive of such regret:
  • Having undergone RALP versus RRP
  • Lower urinary domain scores
  • Lower hormonal domain scores
  • Years since surgery
  • African American race and
  • Lower bowel domain scores

The authors drew the following conclusions from their study data:

• Sociodemographic variables and quality of life were important variables associated with satisfaction and regret, and
• Patients who underwent RALP were more likely to be regretful and dissatisfied, possibly because of higher expectation of an “innovative” procedure.

They recommend that urologists take particular care to portray the risks and benefits of new technologies during preoperative counseling so as to minimize regret and maximize satisfaction.