{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T06:07:17Z","timestamp":1788847637324,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify contemporary drivers of postoperative decision regret 1\u2009year after radical prostatectomy (RP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>In this prospective, multicentre study, patients undergoing robot\u2010assisted RP (RARP) or retropubic open RP (ORP) for localised prostate cancer at seven centres in Germany and Austria (2022\u20132024) completed questionnaires preoperatively and at 1\u2009year postoperatively. Decision regret was assessed using the Decision Regret Scale (DRS). Functional outcomes were measured with European Organisation for Research and Treatment of Cancer quality of life questionnaire \u2013 25\u2010item prostate cancer specific (EORTC QLQ\u2010PR25) symptom scores at 1\u2009year postoperatively. Multivariable logistic regression identified predictors of high surgical decision regret (DRS score \u226510). Sensitivity was tested via propensity score matching (PSM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 419 patients completed the surveys (58% RARP, 42% ORP) at 1\u2009year postoperatively. Surgical decision regret was low (mean [SD] DRS score 9.0\u2009[15.4]). Erectile dysfunction was the outcome that most patients self\u2010reported as worse than expected (54% [221\/404]), followed by urinary incontinence (23% [96\/414]) and oncological cure (10% [39\/397]) in a questionnaire on their retrospective perception. The ORP patients reported higher regret regarding surgical approach than RARP patients (mean [SD] DRS score 11.3\u2009[17.1] vs 7.4\u2009[13.9],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.02). In a multivariate analysis, high urinary symptom burden (odds ratio [OR] 2.4,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.009) and impaired sexual functioning (OR 2.8,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002) independently predicted high surgical decision regret whereas surgical approach and prostate\u2010specific antigen recurrence did not. Sensitivity analyses via PSM confirmed these independent predictors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Surgical decision regret after RP is primarily driven by postoperative functional outcomes rather than oncological results or surgical approach. Optimising functional recovery and managing patient expectations are key strategies to reduce regret in prostate cancer surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70382","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T12:13:32Z","timestamp":1783685612000},"page":"694-704","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Function drives 1\u2010year decision regret in radical prostatectomy: a multicentre prospective study"],"prefix":"10.1111","volume":"138","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1446-2487","authenticated-orcid":false,"given":"Christopher","family":"Hirtsiefer","sequence":"first","affiliation":[{"name":"Department of Urology University Hospital Dresden  Dresden Germany"},{"name":"Vancouver Prostate Centre, M.H. Mohseni Institute of Urologic Sciences University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"K\u00fcmmel","sequence":"additional","affiliation":[{"name":"Department of Urology University Hospital Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Vogelgesang","sequence":"additional","affiliation":[{"name":"Department of Urology University Hospital Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Falkenbach","sequence":"additional","affiliation":[{"name":"Martini\u2010Klinik Prostate Cancer Centre University Hospital Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4775-948X","authenticated-orcid":false,"given":"Mona","family":"Kafka","sequence":"additional","affiliation":[{"name":"Department of Urology Medical University Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemarie","family":"Uhlig","sequence":"additional","affiliation":[{"name":"Department of Urology University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Nestler","sequence":"additional","affiliation":[{"name":"Department of Urology Federal Armed Forces Hospital Koblenz  Koblenz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0875-5120","authenticated-orcid":false,"given":"Cem","family":"Aksoy","sequence":"additional","affiliation":[{"name":"Department of Urology Phillips\u2010University Marburg  Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iva","family":"Simunovic","sequence":"additional","affiliation":[{"name":"Department of Urology Medical University of Graz  Graz 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