Incontinent and impotent after prostate surgery

Side effect and loss of quality of life after prostate surgery

07/25/2012

Prostate surgery often brings significant long-term impairment of quality of life for those affected, according to the results of a study in the context of the 2012 Barmer GEK Hospital Report. Because the patients are quite „become old with a cancer of the prostate“ If it is less threatening than other types of cancer, appropriate surgical procedures should be considered particularly well by the experts of the Barmer GEK.

As reported by Barmer GEK „the majority of patients one year after hospital stay have significant quality of life impairments.“ About 70 percent of the men were suffering from erection problems or incontinence during the first year after prostate surgery, according to the latest research. Instead of a hasty procedure, therefore, often a close observation of the prostate cancer is recommended.

Many patients are not satisfied after prostate surgery
As part of the study presented on Tuesday in Berlin, 1,165 male insured persons of the Barmer GEK, who had undergone a prostate operation, were asked about their assessment of the procedure and the subsequent complaints. The subjects were on average 67.6 years old. Only half (52 percent) of them were fully satisfied with the treatment results after prostate surgery. 41 percent were partially satisfied and seven percent dissatisfied. These are „worse results than after insertion of an artificial hip joint (63 percent unrestricted satisfaction)“, so the message of Barmer GEK. Also, 53 percent of men surveyed complained of sexual disinterest in the first year after the operation and about 16 percent suffered from incontinence. In addition, 20 percent of respondents reported bleeding or bowel injuries related to prostate surgery.

Prostate cancer is the most common male cancer
Prostate cancer is according to the Barmer GEK report „After the skin cancer the man's most common cancer and responsible for about ten percent of cancer deaths among men.“ The prostate cancer therefore has a high supply relevance. In the clinical treatment of prostate cancer „the surgical prostatectomy is by far the most common“, so the message of the largest German health insurance. These „Radical Prostatectomy "is reported in every second case according to the results of the Hospital Report 2012. Although it is gratifying that today 55 percent of interventions „Vascular and nerve preserving“ as opposed to 30 percent in 2005. However, many of these interventions may not be necessary at all, as patients could grow old without prostate cancer surgery. The study authors involved, such as Eva Maria Bitzer of the Institute for Social Medicine, Epidemiology and Health System Research in Hanover, emphasized that in prostate cancer, the treatment does not automatically involve surgery, radiation or medication, but also one „active monitoring“ or that „long-term observation“ often reasonable alternatives.

Aging effect causes massive increase in prostate surgery
In addition to the subjective perceptions of prostate cancer patients, the Barmer GEK study also analyzed the development of the frequency of treatment from 1994 to 2010. The researchers registered „an increase from 14.7 to 20.9 cases per 10,000 men who were under the main diagnosis prostate cancer were treated in the hospital.“ This increase of about 40 percent is exclusively on „the aging effect“ or demographic change, according to the Communication by Barmer GEK. If the aging of the population is excluded, „Thus, the number of inpatient cases remained unchanged in 18 years“, reports the health insurance.

High number of clinical treatment
In view of the deterioration in the quality of life of patients after a prostate operation, the deputy CEO of Barmer GEK, Rolf-Ulrich Schlenker explained that the removal of the prostate is not always the right decision. The extrapolations on the basis of the Barmer GEK data have shown that throughout Germany in 2011 in the „Hospitals performed around 31,000 open radical prostatectomies, 10,000 minimally invasive surgeries, 3,000 brachytherapy treatments, 2,000 chemotherapy treatments and 1,600 percutaneous radiation treatments“, so the numbers in the current release. In total, according to the Deputy Chairman of the Executive Board of Barmer GEK, around 83,000 clinic treatments were carried out nationwide for prostate cancer last year, placing Germany relatively high in international comparison. For example, the United States comes in significantly larger population on the same number of prostate treatments. But the many clinical treatments can not prevent around 13,000 men a year from dying from prostate cancer in Germany, which is a high level in relation to other countries, explained Rolf-Ulrich Schlenker.

Health insurance companies and patients can benefit from abstaining from prostate surgery
The fact that the Barmer GEK not only keeps the interests of the patients in mind, but also their own financial position, goes from the same time as stated „Total costs for inpatient care of prostate cancer patients of the statutory health insurance“ which, according to the authors of the study, amounted to around 364 million euros in 2011. If the number of prostate operations were to be reduced, the costs incurred by Barmer GEK would also be significantly reduced. At this point, the health insurance company and the patients might benefit from a waiver of surgery. The patients due to the avoidance of side effect as well as the maintenance of their quality of life and libido, the health insurance due to the saved costs. (Fp)

Also read about prostate cancer:
Prostate cancer: prevention continues to be the most important weapon
Prostate cancer diagnosis with ultrasound
New prostate cancer test
Coffee protects against prostate cancer
Infertility indicator of later prostate cancer

Picture credits: Martin Büdenbender