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. 2022 Jul:165:187-192.
doi: 10.1016/j.urology.2022.02.008. Epub 2022 Feb 24.

Assessing the Impact of Decision Aid Use on Post Prostatectomy Patient Reported Outcomes

Giulia I Lane  1 , Ji Qi  2 , Ajith Dupati  3 , Stephanie Ferrante  2 , Rodney L Dunn  2 , Roshan Paudel  4 , Daniela Wittmann  2 , Lauren P Wallner  5 , Donna L Berry  6 , Chad Ellimoottil  2 , James E Montie  2 , J Quentin Clemens  2 ; Michigan Urological Surgery Improvement Collaborative
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Assessing the Impact of Decision Aid Use on Post Prostatectomy Patient Reported Outcomes

Giulia I Lane et al. Urology. 2022 Jul.

Abstract

Objective: To evaluate whether completing a decision aid, Personal Patient Profile - Prostate (P3P), prior to prostatectomy, affects self-reported bother from post-prostatectomy urinary incontinence and erectile dysfunction.

Materials and methods: This retrospective analysis included data from men with newly diagnosed clinically localized, very low to intermediate risk prostate cancer who elected for prostatectomy within the Michigan Urological Surgery Improvement Collaborative between 2018-2021. Multivariable logistic regression models were used to estimate the association between P3P use and bother from post prostatectomy erectile dysfunction and urinary incontinence as measured by the Expanded Prostate Cancer Index Composite (EPIC-26).

Results: Among the 3987 patients included, 7% used P3P (n = 266). Men who used P3P reported significantly less bother from erectile dysfunction at 6 months vs non-users (aOR 0.42 [95% CI 0.27-0.66]). At 12 months, the effect of P3P on bother from erectile dysfunction was not statistically significant (aOR 0.62 [95% CI 0.37-1.03]). Men who used P3P did not have a statistically significant difference in bother from urinary incontinence (3-month: aOR 0.56 [95% CI 0.30-1.06]; 6-month; aOR 0.79 [95% CI 0.31-1.97]).

Conclusion: Within the stated limitations of this study, we find that use of a decision aid for localized prostate cancer was associated with decreased odds of men being bothered from sexual dysfunction but not urinary incontinence at 6 months post prostatectomy.

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Figure:
Figure:
Multivariable logistic regression models showing adjusted odds ratio (OR) of patients reporting bother from post prostatectomy erectile dysfunction (ED) at 6 months and 12 months and urinary incontinence (UI) at 3 months and 6 months. White markers and shaded regions represent urinary incontinence models. Adjusted for age, race, ethnicity, family history of prostate cancer, prostate specific antigen value, Gleason score, stage and erectile function at baseline and follow-up or urinary function at follow-up. P3P: Personal Patient Profile-Prostate
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