{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T20:19:59Z","timestamp":1776370799341,"version":"3.51.2"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,24]],"date-time":"2024-02-24T00:00:00Z","timestamp":1708732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJUI Compass"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To prospectively analyse the associations between pre\u2010diagnostic levels of anxiety and depression and patient\u2010reported urinary and sexual adverse effects after radical prostatectomy in a population\u2010based setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>In three Norwegian county hospitals, men referred with a suspicion of prostate cancer were asked to fill out a patient\u2010reported outcome measurement (PROM) questionnaire prior to prostate biopsy. Those who later underwent radical prostatectomy were stratified into three distress groups according to their Hopkins Symptom Checklist 5\u2010score. Additional PROM questionnaires, including the EPIC\u201026 to measure adverse effects, were collected at 6 and 12\u2009months postoperatively. Multivariable mixed models were estimated and post hoc pairwise comparisons performed to explore differences in adverse effects between distress groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 416 men were included at baseline and of those, 365 (88%) returned questionnaires at 6\u2009months and 360 (87%) at 12\u2009months. After adjusting for confounders, men with high distress at baseline had worse urinary incontinence domain score (58.9 vs. 66.8, <jats:italic>p<\/jats:italic>\u2009=\u20090.028), more urinary bother (64.7 vs. 73.6, <jats:italic>p<\/jats:italic>\u2009=\u20090.04) and a higher risk of using incontinence pads (70.6% vs. 54.2%, <jats:italic>p<\/jats:italic>\u2009=\u20090.034) at 6\u00a0months than those with low distress. There was no difference in the sexual domain scores between distress groups postoperatively, but the high\u2010distress group expressed more sexual bother (24.9 vs. 37.5, <jats:italic>p<\/jats:italic>\u2009=\u20090.015) and the intermediate\u2010distress group had a greater probability of using sexual medications or devices (63.8% vs. 50.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.015) than the low\u2010distress group at 6\u00a0months. At 12\u2009months scores generally improved slightly and differences between distress groups were less evident.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Men with higher levels of anxiety and depression before prostate biopsy report more urinary and sexual adverse effects after radical prostatectomy. This should be considered both in treatment decision\u2010making and during follow\u2010up after radical prostatectomy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bco2.334","type":"journal-article","created":{"date-parts":[[2024,2,24]],"date-time":"2024-02-24T04:13:31Z","timestamp":1708748011000},"page":"616-625","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The association between pre\u2010diagnostic levels of psychological distress and adverse effects after radical prostatectomy"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8190-9296","authenticated-orcid":false,"given":"Rasmus","family":"Nilsson","sequence":"first","affiliation":[{"name":"Department of Urology Telemark Hospital Trust  Skien Norway"},{"name":"Institute of Clinical Medicine, Faculty of Medicine University of Oslo  Oslo 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