Relationship between post-prostatectomy urinary incontinence, sexual functions, and dyadic adjustment: A...

Area of Science:

• Urology
• Oncology
• Sexual Medicine
• Relationship Psychology

Background:

• Robot-assisted radical prostatectomy (RARP) is a primary treatment for localized prostate cancer.
• RARP can lead to significant side effects, including post-prostatectomy urinary incontinence (PPUI) and erectile dysfunction (ED).
• These side effects can profoundly affect patients' quality of life and intimate relationships.

Purpose of the Study:

• To investigate the association between dyadic adjustment and the occurrence of PPUI and ED following RARP.
• To identify predictors of PPUI and ED in patients undergoing RARP.
• To understand the impact of these side effects on marital relationships.

Main Methods:

• A cohort of 96 male patients undergoing RARP between January 2019 and December 2021 with at least 12 months follow-up were enrolled.
• Preoperative and 12-month postoperative data were collected using validated questionnaires: IIEF-15 (erectile function), DAS (dyadic adjustment), and UCLA-PCI-UFS (urinary function).
• Statistical analyses, including univariable and multivariable models, were used to assess associations between variables.

Main Results:

• 38.5% of patients experienced social incontinence (>1 pad/day) at 12 months post-surgery.
• Lower dyadic adjustment scores (total, consensus, affectional expression) were significantly associated with incontinence.
• Lower dyadic adjustment scores were also observed in patients with postoperative ED.
• Multivariable analysis identified PPUI and postoperative ED as independent predictors of lower dyadic adjustment.
• Pelvic lymphadenectomy, bladder neck reconstruction, and ED were independent predictors of continence status.

Conclusions:

• PPUI following RARP is independently associated with reduced dyadic adjustment, highlighting its significant impact on marital relationships.
• The findings underscore the complex interplay between urinary continence, sexual function, and relationship satisfaction after prostate cancer treatment.
• Further research is warranted to elucidate the bidirectional relationships and optimize management strategies.