What is lost in an average? Identifying distinct post-radical prostatectomy functional recovery profiles

Authors

Patrick Lewicki
Kevin Ginsburg
Nnenaya Mmonu
Corinne Labardee
Anna Johnson
James O. Peabody, Henry Ford HealthFollow
Adam Gadzinski
Alice Semerjian
Tudor Borza
Brian R Lane
Andrew E Krumm

Recommended Citation

Lewicki P, Ginsburg K, Mmonu N, Labardee C, Johnson A, Peabody J, Gadzinski A, Semerjian A, Borza T, Lane BR, and Krumm AE. What is lost in an average? Identifying distinct post-radical prostatectomy functional recovery profiles. BJU Int 2025.

Document Type

Article

Publication Date

5-15-2025

Publication Title

BJU international

Abstract

OBJECTIVE: To describe, via latent variable mixture modelling, distinct post-radical prostatectomy (RP) patient-reported outcome (PRO) recovery profiles, which are positioned to complement currently disseminated statistical averages for shared decision-making.

PATIENTS AND METHODS: Patients undergoing RP and completing the 26-item Expanded Prostate Cancer Index Composite 12 months after surgery were identified from the Michigan Urological Surgery Improvement Collaborative data registry. Hierarchical cluster analysis and latent variable mixture modelling was applied to urinary incontinence (UI) and sexual function (SF) recovery scores, and final models chosen based on optimal performance.

RESULTS: A total of 3956 patients comprised the study cohort. Three distinct UI profiles were identified with prevalence of 49%, 37% and 14% from best to worst recovery, respectively. Four distinct SF profiles were identified with prevalence of 14%, 24%, 42%, and 20%, from best to worst recovery, respectively. The last two SF profiles had similar function scores but differed based on perception of function being bothersome. Limitations include incomplete PRO capture, which may introduce bias.

CONCLUSIONS: We identify distinct UI and SF recovery profiles and their prevalence from a large, prospectively maintained registry, potentially improving interpretability of PRO data for decision making.

Medical Subject Headings

Humans; Male; Prostatectomy/adverse effects; Middle Aged; Recovery of Function; Prostatic Neoplasms/surgery; Urinary Incontinence/etiology/epidemiology; Aged; Patient Reported Outcome Measures; functional outcomes; functional recovery; localised prostate cancer; patient‐reported outcomes; post‐prostatectomy sexual dysfunction; post‐prostatectomy urinary incontinence; radical prostatectomy

PubMed ID

40374588

ePublication

ePub ahead of print

Volume

136

Issue

4

First Page

633

Last Page

639