Urinary dysfunction is most troubling side effect after RP

Men with prostate cancer who undergo prostatectomy cite sexual dysfunction as the most common side effect after surgery, but urinary dysfunction troubles these patients most, a study from the University of Florida College of Nursing, Gainesville, has found. What’s more, many are not emotionally prepared to face these complications, according to the study, reported in Urologic Nursing (2007; 27:527-33).

“The effects of this treatment are quite immediate and can lead to depression and frustration,” said Bryan Weber, PhD, the study’s lead author. “After an initial diagnosis of prostate cancer, men may be so focused on eradicating the disease that they don’t realize the effects the treatment will have on their quality of life, both for them and their families.”

In the study, UF researchers evaluated 72 men 6 weeks after they underwent prostatectomy. In addition to measuring participants’ physical function and assessing whether they had urinary and bowel symptoms and sexual dysfunction, the researchers also evaluated measures of self-confidence, social support, and uncertainty about the disease and treatment. Most participants were Caucasian, married, and employed full-time or retired.

Fifty-seven percent of the men reported low to moderate social support, indicating that many of the topics proved embarrassing for them to discuss with others, Dr. Weber said. The level of social support was significantly related to urinary problems, revealing that men with urinary incontinence may need more support than those with more control.

“Within the first 100 days of diagnosis, men may be so distressed and so focused on curing their cancer that they don’t focus on these side effects, which is what makes it imperative for health care professionals to educate them on ways that their lives will change and how they can cope,” Dr. Weber said.

Dr. Weber suggests that clinicians assess men and their support systems, identify changes in physical function that may occur as a result of treatment, and direct them to products and services designed to help them cope with the immediate effects of sexual dysfunction and urinary and bowel incontinence.