A systematic review of physical impairments following radical prostatectomy: effect of psychoeducational interventions

Abstract

Aims: To determine the effect of psychoeducational interventions on urinary and faecal incontinence and erectile dysfunction in men 50 years and older after prostatectomy for prostate cancer in comparison to usual care.

Background: Prostate cancer is the second most frequently diagnosed cancer in men worldwide. The major complications of radical prostatectomy are urinary and faecal incontinence as well as sexual dysfunction, associated with significantly reduced quality of life.

Design: A systematic review of randomized controlled trials was undertaken to provide a narrative synthesis and critical appraisal of included studies.

Data sources: The electronic databases MEDLINE and CINAHL were searched using a systematic search strategy for studies published between January 2001-December 2012. In addition, reference lists of included papers were checked. The Cochrane Database was screened for whether a review on this topic already exists.

Review methods: The systematic review included randomized controlled trials in men after prostate cancer treatment and psychoeducational interventions to influence urinary or faecal incontinence and erectile dysfunction. The quality of studies was assessed by the reviewers using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method.

Results: Eight trials met the inclusion criteria. Although these studies are heterogeneous and of varied quality, a descriptive synthesis of results suggests that psychoeducational interventions may improve urinary incontinence, bowel bother, sexual function and sexual bother to some extent.

Conclusion: The results of this systematic review indicate that it would be worthwhile to implement postprostatectomy psychoeducational interventions into nursing discharge planning. Future research is necessary to corroborate these results and define the most favourable time to implement psychoeducational interventions.

Keywords: erectile dysfunction; faecal incontinence; nursing; prostate cancer; psychoeducational intervention; systematic review; urinary incontinence.