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

Introduction

Psychological 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.