Psychosocial Distress in the Early Recovery Period after Radical Prostatectomy

Abstract

<b><i>Purpose:</i></b> 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. <b><i>Patients and Methods:</i></b> 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). <b><i>Results:</i></b> The median patient age was 65 years. At the start of rehabilitation, 204 patients (34.8%) demonstrated high distress. Psychosocial distress decreased significantly (<i>p</i> &#x3c; 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 (<i>p</i> &#x3c; 0.001) from 39.0% at T1 to 58.9% at T2. The median urine volume increased significantly (<i>p</i> &#x3c; 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 (<i>p</i> = 0.001) and tumor stage ≥pT3 (<i>p</i> = 0.006) as independent predictors of high distress. <b><i>Conclusions:</i></b> 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.