Digital Systematic Collection of Data for Patient-reported Outcome and Experience Measures Reveals Real-world Recovery Trajectories After Robot-assisted Radical Prostatectomy.

BACKGROUND AND

OBJECTIVE

Robot-assisted radical prostatectomy (RARP) is widely used for localised prostate cancer (PC). As surgical techniques and oncological outcomes have matured, attention has increasingly turned to patient-reported outcome measures (PROMs) and experience measures (PREMs), driven not only by interest in functional recovery but also by broader health care trends, including shared decision-making, patient empowerment, and value-based care models. Digital health platforms may facilitate this evolution, yet real-world evidence on their feasibility and impact is limited. Our objective was to assess the acceptability, feasibility, and clinical relevance of digital telemonitoring using a certified mobile health application after RARP.

METHODS

We conducted a prospective, multicentre cohort study involving 465 patients undergoing RARP across 32 French centres. All used the Betty digital health platform for perioperative monitoring. The primary outcome was patient-reported satisfaction with perioperative care. Secondary outcomes were pain trajectories, analgesic use, urinary continence, erectile function, and correlations between satisfaction and recovery endpoints. PROM data were collected preoperatively and up to 6 mo postoperatively.

KEY FINDINGS AND LIMITATIONS: The questionnaire completion rate at 6 wk was 86%. Satisfaction was high (median score 9-10), and pain and analgesic use declined steadily over 30 d. The pad-free rate was 59% at 6 wk and 78% at 6 mo. International Index of Erectile Function-5 scores remained low (median 3, interquartile range 1-5 at 6 mo). Satisfaction was correlated with lower pain at postoperative day 7 (r = -0.391, p = 0.001), lower incontinence scores (r = -0.324, p = 0.009), and less impact of incontinence (r = -0.420, p = 0.002). The main limitations are the inclusion of only app users and the absence of nerve-sparing data.

CONCLUSIONS AND CLINICAL IMPLICATIONS: Certified digital telemonitoring after RARP is feasible, well accepted, and linked to high satisfaction. Early pain and continence recovery influence the patient experience. These results support the integration of structured PROM/PREM tracking into standard pathways for real-time monitoring and patient-centred care.