Læknablaðið : fylgirit - 01.06.2009, Blaðsíða 37

27TH CONGR SCAND ASSOC UROL
F Y L G I R I T 6 1
N-04 The influence of intrusive thoughts and social
constraints in maintaining quality of life after prostate
cancer diagnosis
Th K Thorsteinsdóttir', J Stranne, S Ágústsdóttir’, H Valdimarsdóttir3'4, G
Steineck1
1Division of Clinical Cancerepidemiology, The Sahlgrenska Academy, University
ofGothenburg, 2Division ofUrology, Sahlgrenska University Hospital,
Gothenburg, Sweden, 3Department of Psychology, Faculty of Health Sciences,
University oflceland, 4Department of Oncological Sciences, Mount Sinai School
ofMedicine, Nezv York, NY, USA
thordis.thorsteinsdottir@gmail.com, gunnar.steineck@gu.se
Aims: Our aim was to search evidence in published literature if
intrusive thoughts and social constraints influence adaptation
and quality of life of men with prostate cancer.
Method: Literature review of PubMed and CSA databases.
Results and discussion: Six studies were found, four addressed
intrusive thoughts of patients with prostate cancer, one social
constraints and one both topics. Patients that received abnormal
results from cancer screening reported more intrusive thoughts
than a non-screened control group. Intrusive thoughts correlated
negatively to education and time from diagnosis positively to
spousal constraints. Good marital relationships appeared to
buffer psychological distress and moderate the effect of intrusion
on mood disturbance. Furthermore, supportive social relations
improved mental health by aiding the cognitive process of the
cancer experience. Compared to women with gynaecological
cancer, men with prostate cancer did not differ in perceptions of
social constraints. On the other hand, men experienced greater
distress by social constraints from spouse.
Conclusions: Availabie evidence says intrusive thoughts and
social constraints decrease quality of life among men having
contracted prostate cancer. As an implication for future research,
intrusive thoughts and social constraints may constitute
reasonable surrogate end-points for interventions aimed at
increasing quality of life for prostate-cancer survivors. A study
in a large population is in progress.
N-05 Carbohydrate drink vs. fasting after prostatectomy
and nephrectomy
B-1 Dahlin, B Ljungberg
Department of Urology, Umeá University Hospital, Utneá, Sweden
brittinger.dahlin@vll.se
Aim: For elective surgery patients, decreased fasting time re-
duces preoperative discomfort and thirst. We aimed to assess
the effects of a pre-operative carbohydrate drink on hospitaliza-
tion time, drinking the first day postoperative, gut emptying,
return to work and quality of life (QOL) parameters before and
one month after surgery in elective urological patients.
Material and methods: 170 elective urological patients sched-
uled for prostatectomy or nephrectomy was randomized to
either carbohydrate drink (CD) or routine ovemight fasting
(ROF). QLQ-C30 questionnaire responses was collected before
and one month after surgery.
Results and discussion: After prostatectomy, the QOL vari-
able "worry" improved (p=0.027) after CD, but there was no
effect on weight loss. After nephrectomy, the CDs reported less
weight loss (p=0.035), and improved QOL as: "short of breath"
(p=0.038), "feel tense" (p=0.057), "worry" (p=0.035), and "social
activities" (p=0.024). No differences in hospitalization time,
drinking lst day, gut emptying and return to normal activities
were observed.
Conclusions: Patients treated with CD had improved QOL,
particularly in the category 'worry'. Nephrectomy patients
reported less weight loss. CD can improve postoperative QOL.
N-06 How well can outflow obstruction and bladder
overactivity be predicted by a clinical evaluation in men
with LUTS
M Fehrling
Sahlgrenska University Hospital, Gothenburg Sweden
marianne.fehrling@vgregion.se
Aim: Evaluate if bladder outlet obstruction (BOO), overactive
bladder (OAB) and uninhibited overactive bladder (UOB) can
be predicted by clinical non-invasive variables in men with
lower urinary tract symptoms (LUTS) suggestive of benign
prostatic hyperplasia (BPFi).
Patients and methods: Men with LUTS, >40 years old, referred
for an urodynamic investigation. Prostate surgery, neurological
diseases were exclusion criteria. From prostate volume, S-PSA,
IPSS, frequency-volume chart, residual urine and free flow the
probable urodynamic diagnosis and the presence of obstruction
was deduced and recorded. OAB and UOB was diagnosed
according to ICS (2002) criteria and BOO determined according
to Schafer's grade of obstruction.
Results: 62 men, mean age 65 years (40- 89). Mean IPSS was 19±9,
mean prostate volume 43±24 ml. The bladder was predicted to
be normal in 20 patients; this was verified urodynamically in
only 12 (60%). OAB or UOB was predicted in 42 patients and
verified urodynamically in 31 (79%). In 15 (24%) patients it
was impossible to perform a pressure-flow study due to a low
bladder capacity. No obstruction was predicted in 11 patients
but verified urodynamically in only 4 (36%). Obstruction was
predicted in 36 patients but verified in 21 (53%).
Conclusion: OAB and UOB can be fairy well predicted.
Obstruction was more difficult to predict. This suggest that
pressure flow studies are motivated if it is essential to know if
there is a BOO.
N-07 Follow up and new nursing initiatives towards
patients with continence problems as a result of radical
removal of the prostate
S Soenderby, H Bro
Regionshospital Holstebro, Denmark
helle-bro@jubii.dk
In the spring 2004 the urologic ward at Regionshospitalet in
Holstebro started to perform open radical prostatectomy.
LÆKNAblaðiö 2009/95 37