Incontinent and impotent after prostate surgery

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Side effect and loss of quality of life after prostate surgery

Prostate surgery often results in significant long-term impairment of quality of life for those affected, according to the results of an investigation as part of the 2012 Barmer GEK Hospital Report. Since the patients can “grow old with a prostate cancer”, which is therefore less threatening than other types of cancer, according to the experts at the Barmer GEK, appropriate surgical interventions should be considered very carefully.

According to the Barmer GEK, "the majority of patients reported significant impairments in their quality of life one year after hospitalization." According to the results of the current study, around 70 percent of men suffered from erectile problems or incontinence during the first year after prostate surgery. Instead of a hasty intervention, it is therefore often advisable to closely monitor prostate cancer.

Many patients not satisfied after prostate surgery In the course of the study presented in Berlin on Tuesday, 1,165 male insured members of the Barmer GEK who had had a prostate operation were asked about their assessment of the procedure and the subsequent complaints. The subjects were 67.6 years old on average. Only half (52 percent) of them were fully satisfied with the treatment results after prostate surgery. 41 percent were satisfied to a limited extent and seven percent were dissatisfied. These are "worse results than after inserting an artificial hip joint (63 percent full satisfaction)", according to the Barmer GEK. 53 percent of the men surveyed also complained of sexual disinterest in the first year after the operation and around 16 percent suffered from incontinence. In addition, 20 percent of the respondents reported bleeding or bowel injuries in connection with the prostate operation.

Prostate cancer, the most common cancer in men According to the Barmer GEK, prostate cancer is "after skin cancer the most common cancer in men and responsible for around ten percent of cancer deaths among men." Prostate cancer is therefore highly relevant to care. When it comes to clinical treatment methods for prostate cancer, “surgical prostate removal is by far the most common,” according to the largest German health insurance company. According to the results of the Hospital Report 2012, this "radical prostatectomy" is carried out in every second case. Although it is gratifying that 55 percent of the interventions are performed "vessel and nerve-preserving" today - in contrast to 30 percent in 2005. But many These interventions may not be necessary at all, since the patients could grow old without surgery with prostate cancer. The study authors involved, such as Eva Maria Bitzer from the Institute for Social Medicine, Epidemiology and Health System Research in Hanover, emphasized that treatment for prostate cancer surgery, radiation or medication are not automatically required, but “active surveillance” or “long-term observation” are often sensible alternatives.

Aging effect causes massive increase in prostate surgery In addition to the subjective perceptions of prostate cancer patients, the study by the Barmer GEK also analyzed the development of the frequency of treatment from 1994 to 2010. The researchers recorded “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 around 40 percent can only be attributed to“ the aging effect ”or demographic change, according to the Barmer GEK. If the aging of the population is excluded, "the number of inpatient cases remained unchanged in 18 years," reports the health insurance company.

High number of clinical treatments In view of the impaired quality of life in the patients after a prostate operation, the deputy chairman of the Barmer GEK, Rolf-Ulrich Schlenker, explained that the removal of the prostate was not always the right decision. The extrapolations based on the Barmer GEK data showed that in 2011 "around 31,000 open radical prostatectomies were performed in hospitals across Germany, 10,000 minimally invasive operations, 3,000 with brachytherapy, 2,000 chemotherapy and 1,600 percutaneous radiation treatments", the figures in the current release. Overall, according to the deputy chairman of the Barmer GEK, around 83,000 clinic treatments for prostate cancer were performed nationwide last year, which puts Germany relatively ahead in international comparison. For example, the United States has the same number of prostate treatments with a significantly larger population. But the many clinical treatments cannot prevent around 13,000 men from dying from prostate cancer in Germany every year, which is a high level in relation to other countries, explained Rolf-Ulrich Schlenker.

Health insurance companies and patients can benefit from the waiver of prostate surgery The fact that the Barmer GEK not only keeps an eye on the interests of the patients, but also their own financial situation is based on the “total costs for inpatient care of prostate cancer patients” provided by the statutory health insurance “Which, according to the study authors, amounted to around 364 million euros in 2011. If the number of prostate operations could be reduced, the costs incurred at Barmer GEK would also decrease significantly. At this point, the health insurance company and the patients could possibly benefit from a waiver of the operations. The patients because of the avoidance of side effects and the preservation of their quality of life and libido, the health insurance company because of the saved costs. (fp)

Also read about prostate cancer:
Prostate cancer: prevention remains the most important weapon
Ultrasound Prostate Cancer Diagnosis
New prostate cancer test
Coffee protects against prostate cancer
Infertility evidence of later prostate cancer

Photo credit: Martin Büdenbender /

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Video: How to Help Recover Sexual Function After Your Prostate Surgery? Ask a Prostate Expert. PCRI


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