Evidence map›Paper›PMID 42900884›Full record

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

Urinary and sexual function do not mediate psychological distress reduction in the PC-PEP randomized controlled trial A secondary mediation analysis.

Budoor Salman, Nathan K Smith, Gabriela Ilie, Ross Mason, Ricardo A Rendon, Andrea Kokorovic, Cody MacDonald, Nikhilesh Patil, David Bowes, Greg Bailly and 3 more

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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. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

13 authors.

Budoor SalmanDepartment 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.
Ross MasonDepartment of Urology, Dalhousie University, Halifax, NS, Canada.
Ricardo A RendonDepartment 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.
Derek WilkeDepartment of Radiation Oncology, Dalhousie University, Halifax, NS, Canada.
Eva Abou-SamraDepartment of Community Health and Epidemiology, 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

introductionPsychological distress is common among men treated for localized prostate cancer and is often presumed to stem from treatment-related urinary and sexual sequelae. The Prostate Cancer-Patient Empowerment Program (PC-PEP), a six-month, comprehensive, digital intervention, reduces psychological distress and improves patient-reported urinary and sexual function. This secondary analysis tested whether improvements in urinary incontinence, urinary irritative/obstructive symptoms, or sexual function explain PC-PEP's effect on psychological distress.

methodsIn a randomized controlled trial, 128 men with localized prostate cancer were assigned to PC-PEP (n=66) or standard care (n=62) for six months. Psychological distress was measured using the Kessler psychological distress scale (K10), and urinary and sexual function were assessed using the expanded prostate cancer index composite (EPIC) at baseline and six months. Mediation models adjusted for age, relationship status, use of medications for anxiety or depression, Charlson comorbidity index, treatment modality, time from randomization to treatment, and baseline K10 and EPIC scores.

resultsPC-PEP produced significant improvements in urinary incontinence and urinary irritative/obstructive symptoms across the full cohort and attenuated postoperative declines in sexual function; however, none of these urinary or sexual outcomes mediated the program's effect on psychological distress.

conclusionsWhile PC-PEP enhances key urinary and postoperative sexual outcomes, these functional gains do not account for its mental health benefits. This challenges the assumption that psychological distress in prostate cancer survivorship is predominantly driven by urinary or sexual sequelae and highlights the importance of addressing broader psychosocial and behavioral determinants of mental health in survivorship care.

Identifiers

PMID42900884
PMCPMC13660810

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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.