Psychosocial Distress in the Early Recovery Period after Radical Prostatectomy.

PURPOSE: This study aimed to evaluate psychosocial distress in the context of continence and oncological outcome during the early recovery period after radical prostatectomy (RP) for prostate cancer.

PATIENTS AND

METHODS

Retrospectively collected data from 587 patients who underwent inpatient rehabilitation after RP in 2016 and 2017 were analyzed. Psychosocial distress (measured by using a Questionnaire on Stress in Cancer Patients [QSC-R10]) and continence status (urine loss on a 24-h pad test and urine volume on uroflowmetry) were evaluated at the beginning (T1) and end (T2) of a 3-week inpatient rehabilitation. Multivariate logistic regression was performed to identify predictors for high distress (QSC-R10 score ≥15).

RESULTS

The median patient age was 65 years. At the start of rehabilitation, 204 patients (34.8%) demonstrated high distress. Psychosocial distress decreased significantly (p < 0.001) from a median of 11.0 at T1 (median 16 days after surgery) to a median of 6.0 at T2 (median 37 days after surgery). Complete continence increased significantly (p < 0.001) from 39.0% at T1 to 58.9% at T2. The median urine volume increased significantly (p < 0.001) from 161 mL at T1 to 230 mL at T2. Often, distress is higher in younger patients, whereas incontinence is higher in older patients. Multivariate logistic regression analysis identified age ≤69 years (p = 0.001) and tumor stage ≥pT3 (p = 0.006) as independent predictors of high distress.

CONCLUSIONS

Distress and incontinence decreased significantly during the 3 weeks of inpatient rehabilitation after RP. Patient age ≤69 years and tumor stage ≥pT3 are independent predictors of high psychosocial distress.