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Title: Psychosocial predictors of urinary incontinence and sexual dysfunction in the first year post-radical prostatectomy for localised prostate cancer.
Epworth Authors: Pillay, Brindha
Crowe, Helen
Moon, Daniel
Howard, Nicholas
Costello, Anthony
Other Authors: Meyer, Denny
Peters, Justin
Zargar, Homayoun
Nair, R.
Keywords: Robot Assisted Radical Prostatectomy
Localized Prostate Cancer
Urinary Incontinence
Sexual Function
Quality of Life
Psychological Symptoms
Psychosocial Predictors
Expanded Prostate Cancer Index-26
Mixed Model Analyses
Pre-Operative Function
Partner Status
Allied Health Practitioners
Patient Reported Recovery
General Practitioners
Epworth Prostate Centre, Epworth Healthcare, Victoria, Australia
UroRenal, Vascular Clinical Institute, Epworth HealthCare, Victoria, Australia
Australian Prostate Cancer Research Centre Epworth HealthCare, Victoria, Australia
Issue Date: Jun-2017
Citation: Epworth Research Institute Research Week 2017; Poster 36: pp 60
Conference Name: Epworth Research Institute Research Week 2017
Conference Location: Epworth Research Institute, Victoria, Australia
Abstract: BACKGROUND: Robot assisted radical prostatectomy (RARP) is a common treatment for localized prostate cancer. Resultant urinary incontinence (UI) and sexual dysfunction can negatively impact patient wellbeing. Patients' psychological symptoms have also been associated with quality of life outcomes post-surgery. We aimed to assess the psychosocial predictors of UI and sexual function (SF) over time, and assess distress, anxiety and depressive symptoms in the first year post-surgery. METHODS: A review of a prospectively maintained database was performed, examining consecutive RARPs conducted by 3 surgeons between May 2014 and January 2017. A series of measures were completed by 182 men pre-operatively, and at 3, 6, and 12 months post-surgery. Outcome variables were SF, UI, distress, and depression and anxiety symptoms. SF and UI were assessed by the Expanded Prostate Cancer Index-26. Mixed model analyses were used to assess changes in outcomes over time and identify predictors of SF and UI, whilst controlling for pre-operative function, partner status, comorbidity and allied health practitioner involvement,. RESULTS: Anxiety and depression levels remained consistent across time. UI improved significantly (p<.001) from 3 months (M=55.40, SD=25.56) to 6 months (M=69.24, SF=23.86), followed by a non-significant improvement from 6 to 12 months. SF improved significantly over both time periods (p<.001). Higher depressive and anxiety symptoms were associated with worse SF. Similarly, higher distress was associated with worse UI. The proportions of patients who consulted with a General Practitioner (GP), nurse, physiotherapist, and psychologist in the first year post-surgery were 48%, 39%, 59% and 8% respectively. CONCLUSION: Psychological distress may negatively impact patient-reported recovery of UI and SF. Although GPs, nurses and physiotherapists were commonly consulted, fewer men sought psychological services. It is important to educate patients pre-operatively about the potential benefit of engaging with supportive care services.
Type: Conference Poster
Affiliated Organisations: Department of Urology, Royal Melbourne Hospital, Victoria, Australia
Faculty of Health, Arts and Design, Swinburne University of Technology, Victoria, Australia
Department of Surgery, University of Melbourne, Victoria, Australia
Type of Clinical Study or Trial: Prospective Study
Appears in Collections:Cancer Services
Epworth Prostate Centre
Research Month
UroRenal, Vascular

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