Background Prostate cancer (PC) is one of the most common malignant tumors in developed countries. Both PC and treatment for PC have an adverse impact on physical and mental well-being, and are associated with decreased quality of life. The aim of the present study was to examine the relationship between neuropsychological symptoms and clinical course in PC patients undergoing radical prostatectomy with or without adjunct therapy. Methods The cohort comprised 100 patients aged 50–77 years who underwent radical, laparoscopic prostatectomy for PC. Twenty-three patients with a more advanced clinical stage also received adjuvant therapy (radiotherapy and hormonotherapy). Clinical evaluation included self-report assessment, physical examination, and biochemical tests (testosterone and prostate-specific antigen). In addition, the presence and intensity of sexual dysfunction, urinary dysfunction, anxiety-depressive symptoms, and cognitive dysfunction were assessed. Results The group of patients undergoing complex therapy was characterized by a significantly worse result of deferred memory ( p =0.04). A significant correlation was found between post-surgery erectile function and scores for the visual working memory test (correct answers; VWMT-C; p =0.006) and Hospital Anxiety and Depression Scale depression ( p =0.045) and anxiety scores ( p =0.02). A trend toward significance was also observed for simple reaction time (correct answers; p =0.09). A significant correlation was found between results for the delayed verbal memory test and all physical symptoms (International Consultation on Incontinence Questionnaire-total, p =0.02; International Index of Erectile Function-5, p =0.006). Similarly, a significant correlation was found between the VWMT-C and score for sexual dysfunction ( p =0.003). Conclusion Patients undergoing both surgical and adjunct therapy for PC are at risk for psychological burden and cognitive disorders. In the present cohort, physical complications of therapy were associated with depression, anxiety, and delayed memory dysfunction. Furthermore, this study has proven that fewer complications after surgery are associated with better psychological and cognitive functioning. Appropriate neuropsychological and psychiatric care can improve compliance and quality of life among patients after prostatectomy.
Psychiatric disorders are significantly common complications among patients suffering from inflammatory bowel diseases (IBD). Affective temperament is a concept of core personality traits, which can decribe the vulnerability to mood disorders, therefore its evaluation might convey useful information about patients' mental status in autoimmune disorders. The aim of the study was to evaluate the affective temperament in patients with Crohn's disease (CD) and ulcerative colitis (UC) as characteristic features of these diseases, but also in the clinical course and the severity of anxiety and depression.Due to our knowledge this is the first study of this kind. The study enrolled 130 patients with IBD, including 68 with CD and 62 with UC. We used TEMPS-A to evaluate affective temperament and HADS scales to assess the intensity of depressive and anxiety symptoms. Harvey Bradshaw scale, Crohn’s Disease Activity Index (CDAI) and Mayo Score were used to evaluate clinical severity of the diseases. We observed significantly higher prevalence of depressive, cyclothymic and anxiety temperaments in CD patients compared to the control group. Harvey Bradshaw scale, CDAI and Mayo Self Report showed statistically significant outcomes, including significant positive correlations with depressive, cyclothymic and anxiety subscales of TEMPS-A, and negative correlation with the hyperthymic temperament in CD subjects. Our findings indicate significant differences between CD and UC due to temperament traits, and suggest distinct pathogenesis of mood disorders in IBD.
Aim: The aim of this study was to assess the impact of pelvic floor muscle training (PMFT) in the treatment of stress urinary incontinence (SUI) in men after they received radical prostatectomy (RP). Methods: From November 2018 to September 2019, patients who underwent radical prostatectomy were assessed for eligibility. A total of 37 men were then randomly assigned to the experimental group (EG) and the control group (CG). The EG group received supervised exercise twice a week for 12 weeks, and the CG did not receive any intervention. To objectify the results obtained in both groups before and after the intervention, the authors assessed myostatin concentration. Moreover, the Expanded Prostate Cancer Index Composite (EPIC-26) was applied to assess the quality of life, and Beck’s Depression Inventory (BDI-II) was used to measure depression severity. Results: Study results demonstrated a statistically significant reduction of myostatin concentration in the EG following the treatment and no statistically significant differences in this parameter in the CG. In addition, a comparison of the EPIC-26 scores in the EG at the initial and final assessments revealed a statistically significant improvement in the quality of life in each domain. A comparison of the EPIC-26 scores in the CG at the initial and final assessments showed there is a statistically significant decline in quality of life in the “overall urinary problem” and “sexual” domain. A comparison of the BDI-II scores at the initial and final assessments showed a statistically significant decline in depressive symptoms in the EG and no statistically significant differences in the CG. Conclusions: PFMT is an effective treatment for urinary incontinence (UI) in men who received radical prostatectomy.
IntroductionFor many urological procedures the open approach is being replaced by the laparoscopic approach. Laparoscopy technique requires special training conditions. A well-designed, step-by step training program is significantly important for shortening the learning curve.AimThe purpose of the study was to evaluate urology residents’ (UR) experience in laparoscopic procedures, training patterns and facilities available in departments of urology in Poland.Material and methodsThe survey developed by the authors included 18 questions concerning laparoscopy training and was distributed among UR who participated in 2 courses in laparoscopic surgery for UR in Poland in 2017. The survey consisted of questions regarding the number of laparoscopic procedures, acquired laparoscopic experience, laparoscopic simulation training and motivation for further learning.ResultsOf the 2017 invited UR in Poland, 108 (34%) completed the survey. Seventy-two (78%) UR from the study group have access to laparoscopic surgery in their department. Only 20 (25%) of urology departments are equipped with a laparoscopy box and a small number of UR perform regular training. As a primary operator basic (varicocele repair) and advanced (e.g. radical nephrectomy, radical prostatectomy, nephron-sparing surgery) laparoscopic procedures are performed respectively by 55 (71%) UR and 8 (10%) UR. Most residents evaluated their laparoscopic skills as poor (15, 19%), very poor (31, 40%) or absent (10, 13%), while only 22 (28%) evaluated them as at least satisfactory.ConclusionsLaparoscopic technique is available in most Polish training centers. However, the majority of UR consider their skills unsatisfactory. Additionally, a large number of Polish UR do not have access to intensive training. UR considered that their availability of training courses and fellowships is low. Surgical exposure among Polish UR comprises mainly minor laparoscopic procedures.
Purpose Prostate cancer (PC) is one of the most common malignancies in men. The population of PC survivors is growing, and understanding the roles of different factors that affect quality of life (QoL) is important. We investigated the effects of affective temperament on the QoL of PC patients. Patients and Methods All subjects (n=100) underwent medical evaluation [including demographic data, medical history, physical examination, biochemical tests, and assessment of urinary incontinence (ICIQ-UI SF scale) and erectile dysfunction (ED) (IIEF-5 and subjective ED scale)] and psychological evaluation [including assessment of affective temperament using the TEMPS-A scale, depression and anxiety (using HADS), and QoL (EORTC-QLQ-C30 and EORTC-PR25)]. The relationships between individual variables were examined. Results Erection quality after treatment was associated with better QoL in most parameters. Similar strong relationships were observed between the urinary incontinence scale and QoL. Depressive, cyclothymic, irritable, and anxious temperaments were associated with decreased QoL. On the EORTC-PR25 scale, associations were observed between a depressive temperament and worse sexual function and urinary symptoms, between a cyclothymic temperament and worse urinary symptoms, and between an irritable temperament and worse sexual functioning. Multivariate analysis identified the severity of anxiety and depression symptoms measured by HADS as the most important psychological factors affecting QoL. Conclusion QoL in PC survivors depends on many factors, including age, interval since diagnosis, tumor stage, treatment, complications, and affective temperament profile. Depressive, cyclothymic, irritable, and anxious temperaments were associated with poorer QoL in selected domains, which was not observed for a hyperthymic temperament. The temperament profile of patients was associated with mood and anxiety level, which were important determinants of a poorer QoL.
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