Supportive Care in Cancer

, Volume 27, Issue 12, pp 4461–4467 | Cite as

Mood outcomes of a behavioral treatment for urinary incontinence in prostate cancer survivors

  • Amy Y. ZhangEmail author
  • Stephen Ganocy
  • Alex Z. Fu
  • Denise Kresevic
  • Lee Ponsky
  • Gerald Strauss
  • Donald R. Bodner
  • Hui Zhu
Original Article



This study aimed to assess whether prostate cancer survivors who received a behavioral intervention to urinary incontinence had experienced a significant mood improvement.


One hundred fifty-three prostate cancer survivors with persistent incontinence were included in this secondary data analysis. They were randomly assigned to usual care or interventions that provided pelvic floor muscle exercises and self-management skills. All subjects had measures of anxiety, depression, and anger at baseline, 3 months (post-intervention), and 6 months (follow-up). Negative binomial regression analysis was performed to examine the group status, daily leakage frequency at 3 months, and their interactions at 3 months as predictors for mood outcomes at 6 months, controlling for demographic and medical variables.


The main effect of daily leakage frequency at 3 months significantly predicted anxiety at 6 months (p < .01). The group main effect on any mood outcomes at 6 months was not statistically significant. The interaction between the group and 3-month leakage had a significant effect on anxiety; intervention subjects achieving a significant leakage reduction at 3 months exhibited significantly less anxiety at 6 months than other subjects (p = .04). Age, employment status, and receiving surgery at baseline were significantly associated with less anxiety, depression, and anger at 6 months.


Reduced urinary incontinence significantly predicted less anxiety, especially among the intervention subjects. The findings suggest a significant association between a behavioral therapy of urinary incontinence and anxiety reduction in prostate cancer survivors.


Behavioral intervention Anxiety Cancer care Prostate cancer Psychosocial studies 


Authors’ contributions

All the authors have contributed to this article through research participation, data collection or data analysis, and manuscript production.

Funding information

The study was supported by the National Institutes of Health/National Cancer Institute (R01CA127493; PI: Zhang). Cleveland Clinic, University Hospitals Cleveland Medical Center, Louis Stokes Cleveland Veterans Affairs Medical Center, and the MetroHealth System, which are all affiliated with Case Western Reserve University, provided support for patient access.

Compliance with ethical standards

Conflict of interest

The authors declare that they do not have a financial relation with the funding agency NIH except for honoraria received when performing grant reviews. The authors have full control of the primary data that is available for the journal’s review if requested.

Ethical compliance

Informed consent was obtained from all individual participants included in the study. This study has not been published and is not under consideration for publication elsewhere. All authors have contributed to this article through research participation, data collection or data analysis, and manuscript production. They provided financial disclosure under the Conflict of Interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of NursingCase Western Reserve UniversityClevelandUSA
  2. 2.Cancer Prevention and Control ProgramGeorgetown University Medical CenterWashingtonUSA
  3. 3.Department of Veterans Affairs Medical CenterLouis Stokes ClevelandClevelandUSA
  4. 4.School of Medicine; University Hospitals Cleveland Medical Center, Department of UrologyCase Western Reserve UniversityClevelandUSA

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