Symptoms occur after radical prostatectomy but improve within 10 days

Symptoms commonly appear after radical prostatectomy (RP), but these significantly improve over the first 10 days, reveals a study. At the most, severe or very severe symptoms lead to just a small absolute increase in the risk of complications, which can be reassuring to patients and clinicians.

Electronic patient-reported symptom monitoring started in 2016 at the ambulatory surgery centre of the Memorial Sloan Kettering Cancer Center in New York, US. The investigators retrospectively reviewed patients who underwent minimally invasive RP. Participants completed a daily questionnaire using a web interface until postoperative day 10.

Severe symptoms automatically generate a “yellow alert,” while very severe symptoms produce a “red alert.” Messages were sent to the clinic, with an additional prompt to call for those on red alert. Subsequently, the investigators summarized rates of moderate-to-very severe symptoms and fit local polynomial regression. They then compared rates of 30- or 90-day complications (grade ≥2) based on the presence of alert symptoms.

A total of 2,266 men undergoing RP were identified, of whom 1,942 (86 percent) completed surveys. The most common symptoms were pain (72) and dyspnoea (11 percent) among those with moderate-to-very severe symptom levels. Pain, nausea, and dyspnoea subsided consistently over time, while fever and vomiting showed a flat pattern.

Of note, a higher risk of 30-day complications was noted among patients with red-alert symptoms, but the rates were low and between-group differences were nonsignificant (2.9 percent vs 1.9 percent; difference, 1.1 percent, 95 percent confidence interval, 1.3‒3.5; p=0.3). Similar results were observed for 90-day complications.