The association between pre‐diagnostic levels of psychological distress and adverse effects after radical prostatectomy

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Main Authors: Rasmus Nilsson, Thomas Næss‐Andresen, Tor Åge Myklebust, Tomm Bernklev, Hege Kersten, Erik Skaaheim Haug
Format: Artículo Open Access
Published: Wiley 2024
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author Rasmus Nilsson
Thomas Næss‐Andresen
Tor Åge Myklebust
Tomm Bernklev
Hege Kersten
Erik Skaaheim Haug
author_facet Rasmus Nilsson
Thomas Næss‐Andresen
Tor Åge Myklebust
Tomm Bernklev
Hege Kersten
Erik Skaaheim Haug
Rasmus Nilsson
Thomas Næss‐Andresen
Tor Åge Myklebust
Tomm Bernklev
Hege Kersten
Erik Skaaheim Haug
collection Wiley Open Access
contents The association between pre‐diagnostic levels of psychological distress and adverse effects after radical prostatectomy Rasmus Nilsson Thomas Næss‐Andresen Tor Åge Myklebust Tomm Bernklev Hege Kersten Erik Skaaheim Haug BJUI Compass AbstractObjectivesTo prospectively analyse the associations between pre‐diagnostic levels of anxiety and depression and patient‐reported urinary and sexual adverse effects after radical prostatectomy in a population‐based setting.Patients and MethodsIn three Norwegian county hospitals, men referred with a suspicion of prostate cancer were asked to fill out a patient‐reported outcome measurement (PROM) questionnaire prior to prostate biopsy. Those who later underwent radical prostatectomy were stratified into three distress groups according to their Hopkins Symptom Checklist 5‐score. Additional PROM questionnaires, including the EPIC‐26 to measure adverse effects, were collected at 6 and 12 months postoperatively. Multivariable mixed models were estimated and post hoc pairwise comparisons performed to explore differences in adverse effects between distress groups.ResultsA total of 416 men were included at baseline and of those, 365 (88%) returned questionnaires at 6 months and 360 (87%) at 12 months. After adjusting for confounders, men with high distress at baseline had worse urinary incontinence domain score (58.9 vs. 66.8, p = 0.028), more urinary bother (64.7 vs. 73.6, p = 0.04) and a higher risk of using incontinence pads (70.6% vs. 54.2%, p = 0.034) at 6 months than those with low distress. There was no difference in the sexual domain scores between distress groups postoperatively, but the high‐distress group expressed more sexual bother (24.9 vs. 37.5, p = 0.015) and the intermediate‐distress group had a greater probability of using sexual medications or devices (63.8% vs. 50.0%, p = 0.015) than the low‐distress group at 6 months. At 12 months scores generally improved slightly and differences between distress groups were less evident.ConclusionMen with higher levels of anxiety and depression before prostate biopsy report more urinary and sexual adverse effects after radical prostatectomy. This should be considered both in treatment decision‐making and during follow‐up after radical prostatectomy. 10.1002/bco2.334 http://creativecommons.org/licenses/by/4.0/
doi_str_mv 10.1002/bco2.334
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spellingShingle The association between pre‐diagnostic levels of psychological distress and adverse effects after radical prostatectomy
Rasmus Nilsson
Thomas Næss‐Andresen
Tor Åge Myklebust
Tomm Bernklev
Hege Kersten
Erik Skaaheim Haug
BJUI Compass
The association between pre‐diagnostic levels of psychological distress and adverse effects after radical prostatectomy Rasmus Nilsson Thomas Næss‐Andresen Tor Åge Myklebust Tomm Bernklev Hege Kersten Erik Skaaheim Haug BJUI Compass AbstractObjectivesTo prospectively analyse the associations between pre‐diagnostic levels of anxiety and depression and patient‐reported urinary and sexual adverse effects after radical prostatectomy in a population‐based setting.Patients and MethodsIn three Norwegian county hospitals, men referred with a suspicion of prostate cancer were asked to fill out a patient‐reported outcome measurement (PROM) questionnaire prior to prostate biopsy. Those who later underwent radical prostatectomy were stratified into three distress groups according to their Hopkins Symptom Checklist 5‐score. Additional PROM questionnaires, including the EPIC‐26 to measure adverse effects, were collected at 6 and 12 months postoperatively. Multivariable mixed models were estimated and post hoc pairwise comparisons performed to explore differences in adverse effects between distress groups.ResultsA total of 416 men were included at baseline and of those, 365 (88%) returned questionnaires at 6 months and 360 (87%) at 12 months. After adjusting for confounders, men with high distress at baseline had worse urinary incontinence domain score (58.9 vs. 66.8, p = 0.028), more urinary bother (64.7 vs. 73.6, p = 0.04) and a higher risk of using incontinence pads (70.6% vs. 54.2%, p = 0.034) at 6 months than those with low distress. There was no difference in the sexual domain scores between distress groups postoperatively, but the high‐distress group expressed more sexual bother (24.9 vs. 37.5, p = 0.015) and the intermediate‐distress group had a greater probability of using sexual medications or devices (63.8% vs. 50.0%, p = 0.015) than the low‐distress group at 6 months. At 12 months scores generally improved slightly and differences between distress groups were less evident.ConclusionMen with higher levels of anxiety and depression before prostate biopsy report more urinary and sexual adverse effects after radical prostatectomy. This should be considered both in treatment decision‐making and during follow‐up after radical prostatectomy. 10.1002/bco2.334 http://creativecommons.org/licenses/by/4.0/
title The association between pre‐diagnostic levels of psychological distress and adverse effects after radical prostatectomy
topic BJUI Compass
url https://bjui-journals.onlinelibrary.wiley.com/doi/10.1002/bco2.334