A survivorship-oriented enhanced care model for patients undergoing radical prostatectomy

OBJECTIVES: Post-prostatectomy patients experience urinary incontinence, fluctuating quality of life, and psychosocial distress during early survivorship. Evidence-based nursing models addressing long-term supportive needs remain limited. This study developed and evaluated an enhanced survivorship-oriented care model designed to improve postoperative functional recovery and quality-of-life outcomes. METHODS: A retrospective study was conducted at a tertiary urologic center. The improved survivorship model was developed based on our previous PROSTATE care model, integrating nurse-led continuous follow-up, psychosocial support, and structured rehabilitation. A total of 1062 patients who underwent radical prostatectomy between June 2024 and May 2025 received the enhanced survivorship care, compared with 673 patients treated between June 2023 and December 2023 under the previous PROSTATE care model. Outcomes included urinary continence, quality of life, postoperative complications, and length of stay. Between-group comparisons were performed using independent-samples tests, and repeated-measures ANOVA was applied to assess longitudinal changes. RESULTS: Both groups demonstrated significant improvements in urinary recovery and quality of life over time (time × group interaction, P < 0.005). The enhanced-care group showed superior functional recovery, with lower ICIQ-SF scores at catheter removal and 3 months (both P < 0.005), and consistently higher FACT-P scores across all follow-up time points (all P < 0.005), with a large effect size at 3 months (Cohen's d = 0.89). Length of stay was reduced without an increase in overall complication rates. The incidence of urinary fistula was significantly lower in the enhanced-care group (0.76% vs. 2.75%; RR = 0.28, 95% CI 0.12-0.64, P = 0.001). CONCLUSION: The enhanced survivorship care model demonstrated clinically meaningful improvements in quality of life and continence recovery, while maintaining patient safety. These findings support its clinical value and potential for wider implementation as a structured survivorship strategy following radical prostatectomy.