Men’s perceptions of the physical consequences of a radical prostatectomy on their quality of life: A qualitative systematic review

Article type
Authors
Carrier J1, Edwards D1, Harden J1, Morgan L2
1Wales Centre for Evidence Based Care (WCEBC), Cardiff University
2School of Healthcare Sciences, Cardiff University
Abstract
Background: Prostate cancer is the most common male cancer and second-most common cause of cancer death in men in the Western world. Compared to other prostate cancer treatments many trials report worse urinary incontinence and sexual function and similar bowel function among men with prostate specific antigen detected prostate cancer who underwent radicalised prostatectomy (RP).

Objectives: To identify men’s perceptions of the impact of the physical consequences of a RP on their quality of life.

Methods: This review considered studies that focused on qualitative data, included men of all ages and nationalities who had a RP as treatment for prostate cancer, and investigated the psychosocial implications of the physical consequences of RP and the impact of these consequences on quality of life and life experience, as identified by the men.
Standardised Joanna Briggs Institute methods were used.

Results: Eighteen qualitative studies were included in the review. The five aggregated syntheses were:
Urinary incontinence (UI) is a significant problem for which men feel ill prepared, UI causes feelings of powerlessness and negatively impacts on social life and life experience. Healthcare professionals should understand the impact and consequence of UI and implement support interventions to ensure that the negative impact on life experience is minimised.
Erectile Dysfunction (ED) has the greatest impact on men post RP, affecting sexuality and masculinity and causing anxiety, loss and grief.
Acceptance was demonstrated in a number of ways, reconciliation, adaptation and compensation for being rid of the cancer.
Men’s relationships were affected post RP, communication and support from partners was essential and different ways of establishing a sexual relationship were identified.
Pre and post-operative support interventions are essential. Healthcare professionals should provide appropriate information and encourage men to ask about the support they require.

Conclusions: Urinary incontinence and ED are significant side effects of radicalised prostatectomy which have a negative impact on men’s quality of life and for which they feel ill prepared.