a. Background
Prostate cancer is the most common cancer among men in developed countries. There are a variety of treatment options for localized prostatic cancer and radical prostatectomy is the gold standard for surgical management of prostate cancer (1). However, radical prostatectomy can cause a variety of side effects, including urinary, sexual, and bowel dysfunction. Painful urination is an important side effect of prostatectomy (2). This symptom after prostate cancer treatment in men, can significantly impact the quality of life and is closely associated with well-being, emotional instability, depression, anxiety, stress, and insomnia (3).

b. Aims:
The aim of this study was to compare the urinary symptoms severity, quality of life, and impression of symptom severity of men with and without painful urination complaints after prostatectomy.

c. Methods:
After recording detailed demographic and physical characteristics, medical-surgical history, individuals with post-prostatectomy urinary incontinence (PP-UI) and those having no cooperation problems were included in the study. Exclusion criteria were an acute disease, acute prostatectomy surgery (within the first 3 weeks after prostatectomy), neurological disease or neurogenic bladder, pure urgency urinary incontinence, pre-operative incontinence, and previous bladder or other prostate surgeries. It was questioned, "Do you have painful urination?" And the patients were divided into 2 groups. (Group I: PP-UI with painful urination, Group II: PP-UI without painful urination).

Individual's urinary symptom severity and quality of life were evaluated using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-UI SF), 1-hour pad test, King's Health Questionnaire (KHQ), and Patient Global Impression of Severity scale. Mann Whitney-U test was used to compare the data of the 2 study groups. Alpha was set at 0.05.

d. Results:
A total of 68 men who had PP-UI symptoms (age: 64.31±6.95 years, BMI: 27.22± 3.48 kg/m2) were included in this study. There were no statistically significant differences between groups in terms of descriptive characteristics (p>0.05). 

In the comparison between groups, PGI-S scores, KHQ “social limitations” and “symptom severity” subdomains scores in Group 1 were significantly worse than Group 2 (p<0.05). But there was no difference between the groups in the ICIQ-UI sf scores, 1-hour pad test, and other KHQ subdomain scores (p>0.05) (Table 1).

e.      Conclusions:
Prostatectomy can be associated with different adverse effects. Urinary incontinence and erectile dysfunction are the most common side effects after prostatectomy. However, painful urination can also occur after prostatectomy, and this may complicate the management of symptoms. Therefore, it is important to carefully investigate the causes of painful urination. Furthermore, to improve their quality of life and management of urinary symptoms, these patients should be included in a comprehensive physiotherapy program.

f. Clinical Trials Number: NCT04804839

g.      References:
1.           Mottet N, van den Bergh RC, Briers E, Van den Broeck T, Cumberbatch MG, De Santis M, et al. EAU-EANM-ESTRO-ESUR-SIOG guidelines on prostate cancer—2020 update. Part 1: screening, diagnosis, and local treatment with curative intent. European urology. 2021;79(2):243-62.

2.           Turmel N, Ismael SS, Chesnel C, Charlanes A, Hentzen C, Le Breton F, et al. Use of a specific questionnaire and perineal electromyography to assess neuropathic pain after radical retropubic prostatectomy. Asian journal of urology. 2019;6(4):364-7.

3.           Dunphy C, Laor L, Te A, Kaplan S, Chughtai B. Relationship between depression and lower urinary tract symptoms secondary to benign prostatic hyperplasia. Reviews in urology. 2015;17(2):51.