Symptom status and quality of life following prostatectomy
F. J. Fowler Jr, J. E. Wennberg, R. P. Timothy, M. J. Barry, A. G. Mulley Jr and D. Hanley
Center for Survey Research, University of Massachusetts, Boston.
When prostatectomy is proposed as treatment for the symptoms of prostatism,
the decision to operate should depend on how patients evaluate their
symptoms and on objective information about the outcomes. We undertook a
health interview study to determine the probabilities for symptom relief,
improvement in the quality of life, and complications following surgery and
to evaluate patient concern about the symptoms of prostatism. The operation
was effective in reducing symptoms: 93% of severely and 79% of moderately
symptomatic patients experienced improvement; however, a statistically
significant improvement in indices of quality of life occurred only among
patients with acute retention or severe symptoms prior to surgery.
Short-term complications of varying severity occurred in 24% of patients;
in addition, 4% reported persistent incontinence and 5%, impotence.
Patients with similar symptoms reported considerable difference in the
degree to which they were bothered by their symptoms. The result emphasizes
the importance of patient participation in the decision to undergo
prostatectomy.
"You decide doctor". What do patient preference arms in clinical trials really mean?
Bowling and Rowe
J. Epidemiol. Community Health 2005;59:914-915.
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Med Decis Making 1996;16:262-272.
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Black
BMJ 1996;312:1215-1218.
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Oesterling
NEJM 1995;332:99-110.
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Stano
Journal of Health Politics, Policy and Law 1991;16:573-588.
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The Politics of Organ Transplantation: A Parable of Our Time
Rettig
Journal of Health Politics, Policy and Law 1989;14:191-227.
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"Technically Correct and Morally Good": Ethics and Decision Analysis
Friedman
Med Decis Making 1989;9:65-67.
Non-expepimental Methods in the Assessment of Ettieaey
Wennberg
Med Decis Making 1988;8:175-176.
WHEN TO PERFORM PROSTATECTOMY: LET THE PATIENT DECIDE
JWatch General 1988;1988:6-6.
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