Association between presurgical physical activity and urinary and sexual function in prostate cancer patients treated by radical prostatectomy: A prospective cohort study.

[INTRODUCTION] To examine the association of presurgical physical activity with urinary and sexual function following radical prostatectomy for clinically localized prostate cancer.

[METHODS] Participants were recruited from 2011 to 2014 at 2 US institutions and provided self-reported urinary and sexual functions using the modified Expanded Prostate Cancer Index Composite (EPIC, scale from 0 to 100) at baseline (presurgery) and 5-week, 6-month, and 12-month after surgery. Moderate-to-vigorous intensity physical activity (MVPA) was assessed using the Community Healthy Activities Model Program for Seniors and classified into 3 categories. We evaluated changes in function pre- and postsurgery by linear generalized estimating equation (GEE) models and recovery in function after surgery by logistic GEE models.

[RESULTS] Among 401 eligible participants, 38.4%, 35.2% and 26.4% engaged in low, medium, and high MVPA before surgery. Urinary function did not vary by MVPA at baseline or during recovery. For sexual function, patients with high MVPA had better sexual function (p = 0.008) at baseline than those with low or medium levels of MVPA. During the recovery phase, this difference disappeared at 5-week postsurgery but returned by 6-month (p = 0.035) and persisted up to 12-month postsurgery (p = 0.004). A suggestive higher likelihood of sexual function recovery was observed by 12-month postsurgery among participants with high versus low MVPA (OR: 2.42; 95% CI: 0.96-6.08; p = 0.060).

[CONCLUSION] Physically active prostate cancer patients had better sexual function before and after surgery, with a suggestive though statistically non-significant clinical recovery after surgery. These findings support the potential for exercise prehabilitation to improve side effects associated with radical prostatectomy.