Men's perceptions of the impact of the physical consequences of a radical prostatectomy on their quality of life: a qualitative systematic review

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Objective:To identify men's perceptions of the impact of the physical consequences of a radical prostatectomy on their quality of life.Introduction:Prostate cancer is the most common male cancer and second most common cause of cancer death of men in the Western world. Compared to other prostate cancer treatments, trials report worse urinary incontinence and sexual function and similar bowel function among men with prostate-specific antigen detected prostate cancer who underwent radicalized prostatectomy.Inclusion criteria:This review included men of all ages and nationalities who had undergone a radical prostatectomy as treatment for any stage of prostate cancer. It considered studies that investigated:The physical consequences of radical prostatectomy and its impact on quality of life and life experience as identified by the men.The psychosocial implications of the identified physical consequences of radical prostatectomy as identified by the men.Any setting where the topic was addressed with participants meeting the inclusion criteria was included. The review considered studies that focused on qualitative data including, but not limited to: phenomenology, grounded theory, ethnography and action research. Studies were included if they reported results relating to one or more of the phenomena of interest. Studies not written in English were excluded.Methods:The search strategy aimed to find published studies from six databases from database inception to November 2017. Methodological quality of studies was independently assessed by two reviewers using the standardized JBI Critical Appraisal Checklist for Qualitative Research. For data extraction, the standardized Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI) data extraction tool was used. A meta-aggregation was undertaken and the final synthesis of the findings was reached through discussion. Results are presented as five aggregated qualitative syntheses.Results:Nineteen qualitative studies were included in the review. The five synthesized findings were:Urinary incontinence is a significant problem for which men feel ill prepared.The impact of erectile dysfunction on men post-radicalized prostatectomy.Acceptance of the side-effects of radical prostatectomy.The impact of erectile dysfunction on relationships.Physical and psychosocial support are perceived to be essential for men to deal with the physical impact of radical prostatectomy on their quality of life.Conclusions:Urinary incontinence and erectile dysfunction are significant side-effects of radical prostatectomy which have a negative impact on men's quality of life for which they feel ill prepared, and physical and psychosocial support is essential.

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