Evidence map›Paper›PMID 41941257›Full record

ArticleCanadian Urological Association journal = Journal de l'Association des urologues du Canada2026

Mediation analysis of adherence to pelvic floor muscle training and weekly self-monitoring on urinary symptoms in men with localized prostate cancer A secondary analysis of the Prostate Cancer-Patient Empowerment Program (PC-PEP) randomized controlled trial.

Emily Chedrawe, Nathan K Smith, Gabriela Ilie, Ricardo A Rendon, Ross Mason, Andrea Kokorovic, Cody MacDonald, Nikhilesh Patil, David Bowes, Greg Bailly and 4 more

Abstract read
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In one paragraph

Article in Canadian Urological Association journal = Journal de l'Association des urologues du Canada, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Emily ChedraweDepartment of Urology, Dalhousie University, Halifax, NS, Canada.
Nathan K SmithDepartment of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada.
Gabriela IlieDepartment of Urology, Dalhousie University, Halifax, NS, Canada.
Ricardo A RendonDepartment of Urology, Dalhousie University, Halifax, NS, Canada.
Ross MasonDepartment of Urology, Dalhousie University, Halifax, NS, Canada.
Andrea KokorovicDepartment of Urology, Dalhousie University, Halifax, NS, Canada.
Cody MacDonaldDepartment of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada.
Nikhilesh PatilDepartment of Radiation Oncology, Dalhousie University, Halifax, NS, Canada.
David BowesDepartment of Radiation Oncology, Dalhousie University, Halifax, NS, Canada.
Greg BaillyDepartment of Urology, Dalhousie University, Halifax, NS, Canada.
Eva Abou-SamraDepartment of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada.
Alice BourneDepartment of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada.
Liam-Patrick HagermanDepartment of Radiation Oncology, Dalhousie University, Halifax, NS, Canada.
Robert RutledgeDepartment of Radiation Oncology, Dalhousie University, Halifax, NS, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMen treated curatively for localized prostate cancer often experience urinary complications that impair quality of life. The Prostate Cancer-Patient Empowerment Program (PC-PEP) is a six-month, digital intervention integrating pelvic floor muscle training (PFMT), fitness, nutrition, and intimacy support. While early initiation of PC-PEP improves urinary outcomes, the influence of adherence remains unclear. This mediation analysis examined whether reported PFMT duration and engagement with self-monitoring mediate the association between timing of PC-PEP delivery (early vs. late) and urinary outcomes.

methodsIn a randomized, crossover trial, 128 men with localized prostate cancer were assigned to receive PC-PEP immediately (early group, n=66) or after six months of standard care (late group, n=62). Urinary outcomes were assessed using the Expanded Prostate Cancer Index Composite (EPIC) and International Prostate Symptom Score (IPSS). Weekly compliance surveys tracked engagement. Mediation and moderated mediation analyses adjusted for age, comorbidity, treatment modality, and baseline urinary function.

resultsMean reported weekly PFMT duration did not differ between groups. The early group had higher compliance survey completion (98.8% vs. 64.1%, p<0.001) and higher post-intervention EPIC urinary incontinence scores (81.5±21.9 vs. 68.2±17.0, p<0.001), indicating better continence. Compliance survey completion mediated 41% of the association between early intervention and post-intervention EPIC urinary incontinence scores. No significant mediation was observed for IPSS or EPIC irritative/obstructive scores. Treatment modality did not moderate effects.

conclusionsEarly initiation of PC-PEP was associated with greater engagement in structured self-monitoring, which mediated improvements in urinary continence independent of reported PFMT duration. Integrating early patient activation and digital self-monitoring into post-treatment care may improve urinary continence outcomes and support scalable rehabilitation.

Identifiers

PMID41941257
PMCPMC13423274

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.