Surgeon variation in patient quality of life after radical prostatectomy

Arthur Hartz, Tao He, Seth Strope, D. Richard Cutler, Gerald Andriole, Christopher Dechet

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Purpose: We assessed variation among surgeons in patient quality of life outcomes. Materials and Methods: A survey of standard questions used to examine current urinary and sexual function was mailed to 1,500 randomly selected patients from the Utah Cancer Registry who met certain criteria, including prostatectomy for cancer cure more than 1 year previously, current age 70 years or less and no metastatic disease or other cancer therapy. Questionnaire information was linked to cancer registry and hospital discharge abstract information. Hierarchical mixed models were used to examine whether surgeons varied with respect to risk adjusted outcomes. Results: The cooperation rate was 64%. Of the 678 qualifying responders 22% reported leaking urine more than once per day, 7% used more than 1 pad per day and 40% reported no erection without medication. Surgeon variation was significant for 3 patient outcomes, including erectile strength, urine leakage and length of hospital stay (each p <0.001). Surgeon risk adjusted erectile outcomes significantly correlated with leakage outcomes (r = 0.84, p <0.0001) and length of stay (r = -0.55, p = 0.0004). Annual surgeon volume significantly correlated with less leakage and shorter length of stay (r = 0.34 and -0.36, respectively, each p = 0.05). Compared to open retropubic surgery, robotic surgery was associated with a shorter stay. The perineal approach was associated with shorter stay, less urine leakage and weaker erection. Conclusions: Patient quality of life outcomes after prostatectomy varies substantially among surgeons. Administering patient surveys through cancer registries may provide valuable data for improving prostatectomy outcomes statewide.

Original languageEnglish
Pages (from-to)1295-1301
Number of pages7
JournalJournal of Urology
Issue number4
StatePublished - Apr 2013


  • clinical competence
  • penile erection
  • penis
  • prostatectomy
  • quality improvement


Dive into the research topics of 'Surgeon variation in patient quality of life after radical prostatectomy'. Together they form a unique fingerprint.

Cite this