Lower urinary tract symptoms, urinary incontinence, sexual function and quality of life after radical prostatectomy and external beam radiation therapy: real life experience in Austria.

The objective of this study was to assess lower urinary tract symptoms (LUTS), urinary incontinence (UI), erectile dysfunction (ED) and quality of life after radical prostatectomy (RPE) and external beam radiation therapy (EBRT) in a "real-life" setting. A consecutive series of patients undergoing routine follow-up after RPE and EBRT at 28 Austrian institutions were analyzed. Men who received adjuvant therapy were excluded. All patients completed a questionnaire on (a) LUTS and UI, (b) sexual function and (c) quality of life. A total of 364 patients following RPE and 82 after EBRT entered this study and were compared in a matched pair analysis (1:1) based on age, PSA at diagnosis and follow-up (RPE: n=82; EBRT: n=82). Mean time-interval between treatment and current investigation was 4.6 years for RPE and 4.4 years for EBRT (n.s.). UI was reported by 41.3% after RPE and 18.8% after EBRT (P=0.001). Urgency was more frequent after EBRT, this difference, however, did not reach statistical significance. Moderate to severe ED (IIEF-5, <17) was present in 80.0% after RPE and in 80.8% after EBRT (n.s.). On a ten-point scale, RPE-patients rated their quality of life higher (7.3) than after EBRT (6.7) (P=0.01). In this "real-life" setting, RPE and EBRT had significant, yet divergent effects on LUTS, UI and sexual function. The respective numbers were substantially higher than those usually reported by physician-directed studies and centers of excellence.

Frequent use of complementary medicine by prostate cancer patients.

OBJECTIVES: To assess the use of complementary and alternative medicine (CAM) by prostate cancer patients and to characterize CAM-users in this population. METHODS: Prostate cancer patients who underwent routine follow-up at urological practices completed an anonymous, self-administered questionnaire on lower urinary tract function, sexuality, quality of life and use of CAM. All patients with biopsy proven cancer irrespective of age, stage and therapy were eligible. RESULTS: 822 men (69+/-8.5 years; range: 45-95) entered this survey. 245 men (29.8%) used at least one form of CAM, most frequent forms were fat-reduced diet (13.3%), selenium (10.8%) and vitamin E (9.3%). CAM-users did not differ regarding age (68.6 vs. 69.2 years), time interval between diagnosis and current evaluation (4.4 vs. 3.8 years) and PSA at diagnosis (24.9 vs. 18.5 ng/ml) from non-users. CAM-use was dependent on primary therapy (radical prostatectomy: 23.3%, radiotherapy: 31.6%, endocrine therapy: 38.8%) and disease progression. CAM-users were generally less satisfied with their treatment and rated health status and quality of life lower than those not using CAM (all p<0.001). CONCLUSIONS: CAM is used by almost 1/3 of prostate cancer patients in Austria, particularly by those with disease progression, impaired quality of life and treatment satisfaction. Urologists have to be aware of this fact and require a detailed knowledge on this issue to provide objective and evidence-based information.