# Self-reported quality of recovery after radical prostatectomy—a prospective cohort study

## TL;DR

This study compares recovery after two types of prostate surgery, finding that robot-assisted surgery leads to worse early recovery but similar outcomes by discharge.

## Contribution

The study provides new insights into postoperative recovery differences between two prostatectomy techniques using daily patient-reported assessments.

## Key findings

- RARP patients had lower recovery scores on postoperative days one and two compared to ORP patients.
- Recovery scores for both techniques aligned by postoperative day three, showing similar recovery before discharge.
- Surgical technique significantly influenced early postoperative recovery after adjusting for clinical variables.

## Abstract

The Quality of Recovery-15 questionnaire (QoR-15) has been developed to assess patient-reported recovery 24 h after non-cardiac surgery. This prospective cohort study sought to analyze patient-reported recovery throughout day five after open radical retropubic prostatectomy (ORP) and robot-assisted radical retropubic prostatectomy (RARP).

Between June 2022 and February 2023 adult patients, who were scheduled for elective radical prostatectomy, completed the German version of the QoR-15 (QoR-15GE) preoperatively to establish a baseline value. Between postoperative day one and day five, patients completed the QoR-15GE daily until the day of discharge.

A total of 523 patients completed the questionnaires. On postoperative day one QoR-15GE scores were significantly lower after RARP compared with ORP (ORP: 113 ± 22 vs. RARP: 107 ± 24; p = 0.006) with a higher decline in postoperative QoR-15GE scores in RARP compared with ORP patients (ORP: 27 ± 20 vs. RARP: 32 ± 23; p = 0.006). The multivariable analysis confirmed an influence of surgical technique (Estimate: 4.39; 95% CI [0.27; 8.50], p = 0.037) on postoperative quality of recovery after adjusting for clinically relevant variables. Irrespective of surgical technique, we observed a consistent increase in QoR-15GE scores with similar recovery scores on postoperative days three, four, and five.

Patients who undergo RARP experience poorer postoperative recovery at postoperative days one and two compared to those undergoing ORP. However, recovery scores align from postoperative day three, indicating a similar level of patient-reported recovery before hospital discharge. These findings suggest that the QoR-15GE may be appropriate for serial assessments.

The online version contains supplementary material available at 10.1007/s11136-025-04026-6.