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Surgical Approach Not Tied to Decision Regret After Prostatectomy

Functional and oncologic outcomes, autonomous decision-making, and follow-up time influence regret

TUESDAY, March 3, 2020 (HealthDay News) — Surgical approach is not associated with intermediate-term decision regret following radical prostatectomy, according to a study published in the March issue of The Journal of Urology.

Martin Baunacke, M.D., from Technische Universität Dresden in Germany, and colleagues evaluated intermediate-term decision regret after open (532 patients) and robot-assisted (404 patients) radical prostatectomy (2008 to 2013). The analysis included 936 patients who completed follow-up surveys.

The researchers found that patients treated with the robot-assisted procedure showed more self-determined behavior and reported an active role in surgical decision-making and the surgical approach (robot-assisted radical versus open prostatectomy: 39 versus 24 percent and 52 versus 18 percent, respectively). Similarly, patients treated with the robot-assisted procedure more frequently participated actively in selecting the treating hospital (25 versus 11 percent), used the internet often (87 versus 72 percent), and traveled an increased distance (63 versus 42 km). Overall decision regret was low, with a mean score of 14 (scale of 0 [no regret] to 100 [high regret]). Low decision regret (score <15) was predicted by erectile function (odds ratio [OR], 3.2), urinary continence (OR, 1.8), freedom from recurrence (OR, 1.6), an active decision-making role (OR, 2.2), and shorter follow-up (OR, 0.9 per year).

“To our knowledge this is the first study of decision regret in a large and moderately selected cohort undergoing routine care with an intermediate-term follow-up of six years,” the authors write.

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