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Patients' perceptions of radical prostatectomy for localized prostate cancer: a qualitative study.

BACKGROUND
Radical prostatectomy is one option for treating localized prostate cancer, but it can cause functional impairment of the urogenital system.


OBJECTIVES
To describe the outcomes of radical prostatectomy as perceived by the patients, and their ways of coping with them.


METHODS
We conducted a qualitative study of 22 men with localized prostatic cancer 1 year after surgery. The key questions related to the effect of the disease and the surgery on their lives and their view on the value of the surgery.


RESULTS
The surgery was perceived as a necessary solution for the diagnosed cancer. All the participants suffered from varying degrees of urinary incontinence and erectile dysfunction. Urinary incontinence caused severe suffering. The impaired sexual ability affected relations with partners and led to feelings of shame and guilt and a decreased sense of self-esteem. In retrospect, the participants still viewed the surgery as a life-saving procedure. Faith in the surgeon contributed to their affirmation of the decision to undergo surgery despite the difficulties.


CONCLUSIONS
Patients were prepared to suffer the inevitable physical and psychological sequelae of radical prostatectomy because they believed the surgery to be a definitive solution for cancer. Surgeons advising patients with localized prostatic cancer on treatment options should address these difficult issues and provide psychological support, either themselves or in collaboration with professionals.