Quality of life after retropubic radical prostatectomy in Conakry: Functional and psychosocial impact

Abstract

Introduction: Radical prostatectomy remains the standard treatment for localised prostate cancer. However, it carries the risk of functional complications, mainly urinary incontinence and erectile dysfunction. This pioneering prospective study aimed to evaluate the functional and psychosocial impact one year after radical prostatectomy in the newly established context of urologic oncologic surgery in Conakry.

Methods: This was a prospective, descriptive study conducted in two centres from 25 October 2021 to 24 October 2024. It included 22 patients with non-metastatic prostate cancer who underwent radical prostatectomy with a 12-month postoperative follow-up. Urinary and sexual functions were assessed using validated questionnaires: ICS (incontinence), IIEF-5 (erectile function), EQS (erection quality), and TSS (sexual satisfaction). Data are presented as mean (±) and frequency (%).

Results: The mean age of patients was 65.5 ± 4.2 years. Before surgery, all patients were continent (ICS score = 0) and 86.36% had no erectile dysfunction. At 12 months, persistent incontinence was observed in 36.36% of patients, whereas 31.82% had severe erectile dysfunction. Half of the patients (50.0%) reported overall sexual dissatisfaction. The psychosocial impact was notable: 31.82% avoided places of worship and 59.09% avoided family gatherings due to functional sequelae.

Conclusion: This preliminary study shows that despite progressive improvement in continence, urinary and sexual sequelae of radical prostatectomy persist at one year and significantly impair quality of life. Multidisciplinary care adapted to the sociocultural context is necessary.