ASPO Abstracts
Association between pre-surgical physical activity and urinary and sexual outcomes in prostate cancer patients undergoing radical prostatectomy: a prospective cohort study
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2023
Abstract Body:
Purpose of the study: To examine the association of pre-surgical physical activity with urinary and sexual outcomes following radical prostatectomy for clinically localized prostate cancer in the Prostatectomy, Incontinence and Erectile Dysfunction (PIE) study. Methods: Study participants were recruited from 2011 to 2014 at two US institutions. Participants provided self-reported information on urinary and sexual outcomes using the modified Expanded Prostate Cancer Index Composite (EPIC, scale from 0-100) at baseline (pre-surgery) and 5 weeks, 6 months, and 12 months after surgery. Recent physical activity was assessed using the Community Healthy Activities Model Program for Seniors at the same four time points and was classified into three categories corresponding approximately to tertiles: <5 hours/week (low), 5 to <10 hours/week (moderate), and ≥10 hours/week (high) of moderate-to-vigorous physical activity (MVPA). Results: Among 401 eligible participants, 38.4%, 35.2% and 26.4% engaged in low, moderate, and high MVPA at baseline prior to surgery. In both multivariable- adjusted linear and logistic generalized estimation equation (GEE) models, urinary function did not vary by MVPA at baseline, or during recovery. For sexual function, multivariable-adjusted linear GEE models suggested that patients with high MVPA had higher sexual function scores (p = 0.008) at baseline than those with low or moderate MVPA. During the recovery phase, this difference disappeared at 5-weeks post-surgery, but returned by 6-months (p = 0.035) and persisted up to 12-months post-surgery (p = 0.004). In multivariable-adjusted logistic GEE models, no significant associations were observed between MVPA and recovery of sexual function, though we did observe a suggestive higher likelihood of recovery of sexual function (OR: 2.42; 95% CI: 0.96-6.08; p = 0.060) by 12-months post-surgery among participants engaging in high than low MVPA. Conclusion: Physically active prostate cancer patients had better and likely earlier recovery in sexual function post-surgery. These findings support the potential for brief exercise prehabilitation to improve side-effects associated with radical prostatectomy.
Keywords: Physical activity, radical prostatectomy, prostate cancer, urinary and urinary function, prehabilitation