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Background Young adult testicular cancer survivors experience adverse impacts after treatment. We developed Goal-focused Emotion-regulation Therapy (GET) to improve distress symptoms, emotion regulation, and goal navigation skills. Purpose This pilot study examined GET versus an active control intervention in young adult survivors of testicular cancer. Methods Seventy-five eligible survivors treated with chemotherapy were randomized to receive GET or Individual Supportive Listening (ISL). Study acceptability, engagement, and tolerability were examined, and intervention fidelity and therapeutic alliance were compared between arms. Preliminary efficacy was evaluated by effect sizes for between-group changes in primary (anxiety and depressive symptoms) and secondary (career confusion, goal navigation, and emotion regulation) outcomes from baseline to immediately and 3-month post-intervention. Results Among the 38 men randomized to GET, 81.1% completed all study sessions compared with 82.4% of the 37 men assigned to ISL. Fidelity to the intervention was 87% in GET. Therapeutic alliance wassignificantly higher among those receiving GET versus ISL. Participants exhibited a medium group-by-time effect size with greater reductions in depressive (d = 0.45) and anxiety (d = 0.29) symptoms for those in GET versus ISL, with a similar pattern at 3 months for depressive (d = 0.46) and anxiety (d = 0.46) symptoms. Conclusions GET is a feasible and acceptable intervention for reducing adverse outcomes after testicular cancer for young adults. Observed effect sizes preliminarily suggest meaningful change, though should be interpreted with caution in small samples. GET may be a developmentally-matched behavioral approach to improve psychosocial function in this cancer group. Clinical Trial information Clinicaltrials.gov, NCT04150848. Registered on October 28, 2019.

INTRODUCTION AND OBJECTIVE: Our group previously published that maximization of membranous urethral length (MUL) during radical prostatectomy (RP) yields a significant improvement in continence recovery rates following RP. The present study seeks to further investigate the role of MUL preservation in improving urinary bother (QoL), American Urological Association Symptom Score (AUASS), and continence status following RP.METHODS: A retrospective analysis was conducted on RP patients from November 2004 to November 2018. Inclusion criteria consisted of RP as primary intervention, pad-free status at time of surgery, minimum 2-year follow-up, and outcome data availability at pre-op, 3 months, and one other time point. Primary outcomes were urinary symptoms measured by AUASS and QoL. Secondary outcomes were continence rates through pad-free status. Agestratification was conducted to investigate its confounding effect. While primary analysis used t-test and chi-squared, ad-hoc paired difference analysis was also performed.RESULTS: No differences in mean AUASS and QoL were observed for the overall sample. However, mean differences were greater for patients older than 65 years during paired difference analysis after the technique change (Figure 1A-B). Sample continence rates were reported as 34%, 72%, and 92% prior to the technique change and increased to 52% (p<0.001), 95% (p<0.001), and 96% (p[0.011) at 30-day, 9-month and greater than 15-month follow-up points, respectively (Table 1).CONCLUSIONS: This technique change significantly improved QoL and AUASS for those over the age of 65, those at highest risk for adverse symptoms as supported by their higher pre-and post-operative mean AUASS and QoL scores. Men under 65 did not show this substantial benefit. Time to continence improved for all patients. The results support the implementation of MUL maximization. However, further trials are encouraged.