The American Journal of Public Health Promoting The Mental Health Of Urology Patients: A Case Study. *Corresponding Author: Bashar Hadi Shalan. Anaesthesia Techniques Department, College of Health and Medical Techniques, Al-Mustaqbal University, 51001, Babylon, Iraq. and College of Medicine, Al-Mustaqbal University, 51001 Babylon, Iraq. Email: mohseoud@gmail.com. Received: 02-Oct-2025, Manuscript No. TAJOPH - 5467; Editor Assigned: 04-Mar-2026 ; Reviewed: 16-Mar-2026, QC No. TAJOPH - 5467 ; Published: 16-Apr-2026.DOI: 10.52338/tajoph.2026.5467. Citation: Bashar Hadi Shalan. Promoting The Mental Health Of Urology Patients: A Case Study.The American Journal of Public Health. 2026 April; 16(1). doi: 10.52338/tajoph.2026.5492. Copyright © 2026 Bashar Hadi Shalan. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. ISSN 3064-6677 Research Article Bashar Hadi Shalan 1&2 , Nabeel Kareem Abdul-Kadhim Al-Eidan 2 , Rania Abd ElMohsen Abo El Nour 3 and Ahmed neamah abed 1 1. Anaesthesia Techniques Department, College of Health and Medical Techniques, Al-Mustaqbal University, 51001, Babylon, Iraq. and College of Medicine, Al-Mustaqbal University, 51001 Babylon, Iraq. 2. Urologist (FICMS), Department of surgery, Al-Imam Al-Sadeq Teaching Hospital, Babylon 51001, Iraq. 3. Community Health Nursing Department, Beni-Suef Health Technical Institute, Ministry of Health, Beni-Suef 62511, Egypt. www.directivepublications.org Abstract Urological pathologies exert profound effects on both the physiological integrity and psychological homeostasis of male patients, underscoring the critical necessity for integrating psychiatric support within standard urological practice. The present review investigates the psychosocial morbidity intrinsic to conditions such as prostate carcinoma and erectile dysfunction distress that is frequently exacerbated by entrenched normative masculine paradigms that actively deter health-seeking behaviors. Furthermore, this article elucidates the imperative for a biopsychosocial care model capable of concurrently managing somatic symptomatology and its associated psychological sequelae. Ultimately, the authors advocate for a systemic paradigm shift toward multidisciplinary, comprehensive care. By emphasizing the necessity of augmented psychosocial training for urological practitioners and the active deconstruction of societal stigmas, this framework aims to optimize clinical outcomes and establish an elevated standard of care in men's health. Keywords: Urological Pathologies, Physiological Integrity; Care in Men's Health.

Directive Publications Bashar Hadi Shalan GRAPHICAL ABSTRACT Page - 2Open Access, Volume 16 , 2026 INTRODUCTION Within the contemporary paradigm of men's health, the convergence of urological pathology and psychiatric morbidity constitutes a multifaceted clinical challenge, necessitating comprehensive, multidisciplinary management strategies. Epidemiological estimates suggest that approximately 2.68 billion adult males globally suffer from depressive disorders [1]. However, this prevalence likely represents a substantial underestimation, largely attributable to the well-documented reluctance among men experiencing psychiatric distress to initiate professional health-seeking behaviors [2]. Urological conditions encompassing benign prostatic hyperplasia and erectile dysfunction, as well as malignant neoplasms such as prostate and bladder carcinomas impose not only a significant somatic burden but also precipitate profound psychological sequelae. Empirical evidence demonstrates a robust correlation between these domains; notably, depressive symptomatology is reported by up to 18% of men diagnosed with prostate cancer and 43.1% of those experiencing erectile dysfunction.3, 4 These substantial psychosocial ramifications highlight the critical necessity for a biopsychosocial care model capable of simultaneously ameliorating both physiological manifestations and concurrent psychiatric morbidity [3]. While conservative survey-based estimates indicate a lifetime prevalence of 17% for major depressive disorder (MDD) and 6% for generalized anxiety disorder, recent data suggest the global point prevalence of MDD (2021–2025) may be as substantial as 35% (95% CI: 0.30-0.38) [4-7]. Despite the widespread nature of these conditions, there is a pronounced paucity of research examining mental health issues (MHI) in the context of urology, with existing studies overwhelmingly focused on urologic oncology. This analysis seeks to address this critical literature gap by evaluating MHI in non-oncological urology patients. Ultimately, this work endeavors to raise clinician awareness, foster greater comfort in discussing mental health, and promote timely psychiatric referrals for vulnerable individuals [8-10]. The intricacies of this issue are exacerbated by traditional masculine norms that deter men from expressing vulnerability, frequently resulting in underdiagnosis and inadequate psychiatric treatment [11]. Because urological conditions are often intrinsically linked to perceptions of masculinity, they can precipitate profound psychological distress, increasing the risk of social isolation, diminished self-worth, and crises of identity [12]. Consequently, a holistic therapeutic paradigm is imperative one that addresses clinical symptomatology while simultaneously dismantling the sociocultural barriers that impede psychological help seeking. At present, the incorporation of mental health services

Bashar Hadi Shalan Directive Publications Page - 3Open Access, Volume 16 , 2026 within urological practice remains nascent. This integration is largely hindered by persistent stigma, widespread knowledge deficits, and insufficient psychiatric training among urologic providers [13]. These systemic deficiencies underscore the critical need for a multidimensional approach to men's health that encompasses both physiological and psychosocial domains, ultimately optimizing patient outcomes and overall quality of life [14]. The assimilation of mental health services into urological practice represents a critical transition toward a holistic healthcare paradigm that concurrently addresses physiological and psychological morbidities [15-16]. While this paradigm shift must overcome established barriers, such as societal stigma and deficits in specialized training, the trajectory of urological care is promising driven by novel care pathways, supportive health policies, and ongoing research. Echoing the World Health Organization's assertion that there is "no health without mental health," this integrated approach highlights the indivisibility of physical and psychological well- being [17]. Urologists are uniquely positioned to spearhead this transformation by proactively screening for psychiatric distress, counseling on behavioral modifications, and facilitating appropriate referrals. By adopting a gender- specific framework analogous to the role of gynecology in women's health, urologists can redefine clinical excellence, fundamentally elevate the standard of men's healthcare, and ensure comprehensive patient management [18]. UNIQUE PSYCHOLOGICAL CHALLENGES The psychological sequelae of urological pathologies extend beyond mere somatic manifestations, significantly impacting masculine identity and overall psychological well-being. A diagnosis of prostate cancer the second most prevalent malignancy among men globally precipitates acute psychiatric distress alongside physiological morbidity. With an estimated 1.4 million incident cases annually, a substantial patient demographic is vulnerable to the mental health repercussions associated with such diagnoses [19-20]. Following diagnosis, patients frequently enter a bidirectional feedback loop wherein psychological distress amplifies physical symptomatology, subsequently compounding psychiatric morbidity (Figure 1). Furthermore, conditions such as anxiety, depression, and chronic stress often exacerbated by the iatrogenic effects of treatment and existential concerns regarding mortality frequently outlast active clinical management, thereby persistently impairing survivorship and health-related quality of life [21]. Figure 1. The inhibiting influence of psychiatric stigma on healthcare-seeking behaviors among male patients presenting with neurological disorders.

Bashar Hadi Shalan Directive Publications Page - 4Open Access, Volume 16 , 2026 This psychosocial burden is further exacerbated by traditional masculine norms, which frequently equate fortitude with the suppression of vulnerability. Although the prevalence of psychiatric morbidity is comparable across genders, male patients demonstrate a markedly reduced propensity for mental healthcare utilization; a disparity starkly evidenced by a male suicide mortality rate that is threefold higher [22]. These epidemiological realities necessitate a systemic adaptation within healthcare infrastructures to provide targeted interventions that address the unique psychosocial challenges encountered by men with urological morbidities. Mitigating this crisis requires a paradigm shift toward a comprehensive, interdisciplinary model of urological care. This framework acknowledges the complex interplay between somatic and psychological health, promoting a clinical environment conducive to transparent communication and proactive help-seeking behaviors [23]. Clinicians are therefore tasked with integrating psychiatric support into standard urological management, formulating holistic care pathways that address the complete continuum of patient needs [24-25]. The adoption of this integrated care model facilitates the clinical recognition and management of the psychological sequelae associated with urological pathologies. This comprehensive approach has the potential to optimize patient outcomes and elevate health-related quality of life, advancing a paradigm of urological care focused on biopsychosocial well- being. Consequently, the therapeutic trajectory addresses both somatic and psychological domains, representing a substantial progression in the clinical management of urological health [26]. OVERCOMING STIGMA IN MEN'S UROLOGICAL HEALTH Societal stigma, underpinned by traditional masculine norms that emphasize stoicism and stigmatize vulnerability, serves as a significant deterrent to healthcare utilization among men experiencing urological and psychiatric morbidities. This stigmatization is especially pronounced concerning urological pathologies, such as erectile dysfunction and prostate carcinoma, given their intricate association with societal constructs of virility and manhood [27-28] Patients confronting these conditions frequently report profound psychological distress, feelings of inadequacy, and apprehension regarding social judgment and the perceived erosion of their masculine identity. The internalization of the belief that help-seeking equates to weakness further compounds their reluctance to engage with essential medical and psychological interventions, thereby exacerbating clinical symptomatology and significantly deteriorating their health- related quality of life [29]. Furthermore, pervasive psychiatric stigma exacerbates this paradigm, frequently resulting in the minimization or invalidation of male psychological distress. This societal apprehension impedes transparent communication regarding emotional well-being and deters the proactive initiation of psychotherapeutic interventions. Consequently, this avoidance behavior adversely impacts both psychiatric and somatic health trajectories, particularly in the context of urological pathologies. This is empirically supported by data indicating that men diagnosed with prostate or bladder cancer who possess pre-existing psychiatric comorbidities exhibit significantly elevated cancer-specific mortality rates within a 1-to-10-year period compared to cohorts without such diagnoses. Notably, a history of psychiatric hospitalization correlates with an approximately twofold increase in the risk of mortality from prostate or bladder malignancies [30]. These stark epidemiological findings underscore the detrimental impact of untreated psychiatric conditions on both the clinical management and prognostic outcomes of urological diseases, reinforcing the imperative for a multidisciplinary care model that integrates psychological and somatic therapies. Mitigating these barriers requires a multidimensional strategy aimed at reconstructing societal paradigms of masculinity and health behavior. Public health initiatives must prioritize the destigmatization of urological and psychiatric conditions, promoting a more expansive conceptualization of masculinity that normalizes vulnerability as an inherent aspect of the human experience. Such systemic efforts possess the potential to significantly reduce the threshold for male healthcare utilization [31-33]. Healthcare professionals, particularly within the urological specialty, serve as pivotal agents in facilitating this cultural transition. By cultivating a supportive and empathetic clinical environment, providers can elicit transparent dialogue regarding health concerns, thereby establishing psychiatric screening and psychosocial support as foundational elements of standard urological practice. Ultimately, this integrated care paradigm holds the promise of dismantling existing barriers to access, establishing a novel standard for comprehensive clinical practice, and substantially optimizing prognostic outcomes for men navigating these concurrent morbidities [34]. SYSTEMIC BARRIERS TO INTEGRATED MENTAL HEALTH CARE IN UROLOGY The assimilation of psychiatric support within urological practice is significantly impeded by structural obstacles, particularly concerning practitioner education and systemic healthcare architecture. Such deficiencies obstruct the delivery of comprehensive patient management, underscoring the imperative for an integrated clinical paradigm that concurrently prioritizes both the somatic and

Bashar Hadi Shalan Directive Publications psychological well-being of male patients presenting with urological pathologies [35]. Contemporary urological education predominantly emphasizes the somatic dimensions of disease, offering minimal instruction regarding associated psychological sequelae. Consequently, practitioners often lack the requisite competencies to address the psychiatric facets of patient management. To rectify this instructional deficiency, it is imperative to systematically integrate mental health modules into urological curricula. Such pedagogical enhancements must encompass the identification of psychological distress, the application of empathetic communication protocols, and the facilitation of appropriate psychiatric referrals, thereby equipping clinicians to deliver comprehensive, patient- centered care [36-38]. Systemic silos within healthcare infrastructures commonly impede the efficacious integration of mental health provisions into urological practice, ultimately compromising the continuity of patient support. Implementing unified healthcare frameworks utilizing multidisciplinary teams and co-located clinical facilities can substantially improve coordination among specialized providers [39-40]. This methodological shift ensures that comprehensive care is accessible directly within the urological clinical setting, thereby facilitating prompt psychological interventions. Mitigating both sociocultural and institutional stigmas surrounding psychiatric health is essential to facilitate transparent clinical discourse and attenuate patient hesitation regarding help-seeking behaviors. Targeted interventions designed to destigmatize psychological care effectuated via psychoeducation, advocacy initiatives, and comprehensive patient resources are instrumental in cultivating a more inclusive clinical milieu [41]. Such a paradigm shift is imperative for normalizing psychiatric discussions within urological settings and advancing cohesive care models capable of addressing the full continuum of patient health requirements. Ameliorating these obstacles necessitates both methodological modifications in clinical practice and a fundamental paradigm shift regarding the conceptualization of mental health within the urological discipline. By actively endorsing the assimilation of psychiatric support, urologists can serve as vital catalysts in the advancement of holistic treatment, guaranteeing that patients are afforded the comprehensive care requisite for both somatic and psychological wellness. Such initiatives harmonize with the overarching healthcare directive asserting that mental well-being is intrinsically linked to general health, thereby compelling urological specialists to pioneer the integration of psychiatric care within their domain [42-45]. COMPREHENSIVE PSYCHOLOGICAL SUPPORT MODELS: CURRENT INTERVENTIONS AND ASSOCIATED EFFICACY DATA The assimilation of psychiatric services within urological practice represents a pivotal transition toward comprehensive patient management, highlighting the inextricable link between somatic and psychological well-being. Consequently, this clinical synthesis has catalyzed the development of novel, holistic care paradigms, yielding measurable improvements in both patient satisfaction metrics and broader health outcomes. The spatial integration of psychiatric services within urology departments has emerged as a critical intervention, facilitating immediate patient access to mental health practitioners. Such co-location paradigms are especially advantageous for cohorts subjected to highly distressing clinical protocols, notably men navigating prostate cancer diagnoses. In these specific contexts, the incorporation of psycho-oncology support has been empirically shown to substantially elevate psychological resilience while simultaneously optimizing adherence to primary therapeutic regimens [46]. Telemedicine has significantly broadened the availability of psychiatric intervention, systematically dismantling historical impediments to healthcare access. Utilizing virtual psychotherapy and digital peer support networks, telehealth frameworks have effectively mitigated psychological distress specifically isolation, clinical depression, and anxiety proving indispensable for demographics situated in geographically isolated or resource-deficient regions. The favorable efficacy of these synchronized healthcare paradigms underscores the systemic imperative for medical infrastructures to evolve toward a comprehensive, biopsychosocial approach. Consequently, by prioritizing the amalgamation of psychological and somatic clinical services, the discipline of urology is positioned to transition toward a standard of exhaustive, patient-centric care. This integration ultimately anticipates enhanced prognostic outcomes and an elevated health-related quality of life for individuals managing urological pathologies [47]. PRACTICAL RECOMMENDATIONS FOR UROLOGISTS A sustained dedication to comprehensive clinical paradigms will catalyze an evolutionary shift within urological practice, ultimately optimizing both the somatic and psychological trajectories of patients. The systematic implementation of the methodologies delineated herein constitutes a pivotal advancement toward the assimilation of behavioral and psychiatric services into urology. Consequently, this integration fosters a robust, patient-centric framework meticulously designed to address complex, multidimensional clinical requirements. Page - 5Open Access, Volume 16 , 2026

Bashar Hadi Shalan Directive Publications Page - 6Open Access, Volume 16 , 2026 • Early detection through screening The integration of routine psychological screening during baseline clinical evaluations is of paramount importance, necessitating the use of validated psychometric instruments such as the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) scale. The prompt detection of psychiatric symptomatology facilitates expeditious clinical intervention and appropriate specialist triage. Consequently, this early identification establishes the foundation for a comprehensive, highly efficacious therapeutic regimen that concurrently manages both somatic and psychobehavioral comorbidities (Figure 2), [48]. • Education and professional development It is imperative that urological clinicians prioritize continuous medical education regarding the psychobehavioral dimensions of urological practice. Active engagement in specialized didactic initiatives specifically those focusing on health psychology and psycho-oncology substantially augments the practitioner's capacity to deliver holistic clinical management. Furthermore, the cultivation of foundational psychotherapeutic competencies and a comprehensive understanding of psychiatric referral algorithms are requisite for the provision of empathetic, evidence-based patient care. • Collaborative multidisciplinary care The cultivation of robust, interdisciplinary referral pathways with psychiatric and psychological specialists ensures the comprehensive evaluation of all patient health domains. Such a collaborative clinical paradigm engenders a synergistic, biopsychosocial therapeutic strategy, thereby substantially optimizing the treatment continuum and overall patient outcomes [49]. • Patient education and support Proactively counseling patients regarding the prospective psychosocial sequelae of their urological pathologies, in conjunction with advocating for participation in peer-support networks and formal psychotherapy, can effectively attenuate social isolation and destigmatize psychological distress. Consequently, structured patient education remains an indispensable component in fostering patient autonomy and facilitating active engagement throughout the rehabilitative trajectory. Figure 2. Impact of anxiety and depression on care.

Bashar Hadi Shalan Directive Publications • Utilising telehealth Telemedicine interventions have demonstrated substantial efficacy in expanding psychiatric support beyond traditional clinical settings, thereby facilitating accessible and uninterrupted care for demographics residing in geographically isolated or resource-constrained regions [50]. Empirical evidence indicates that telephonic psychoeducation and interpersonal psychotherapy can markedly enhance psychological health outcomes. This modality facilitates continuous longitudinal surveillance and sustained patient engagement between scheduled outpatient encounters. Consequently, it enables both urological clinicians and behavioral health specialists to deliver consistent psychiatric management, capitalizing on the accessibility and clinical utility of digital health infrastructures. CONCLUSION The incorporation of psychological interventions within the urological domain denotes a fundamental paradigm shift toward a biopsychosocial healthcare framework, effectively bridging the historical divide between physiological pathologies and cognitive-emotional well-being. This evolution transcends conventional biomedical silos, advocating for a holistic clinical approach that addresses the psychosomatic complexities of patient care. While systemic impediments specifically sociocultural stigma and the exigency for specialized practitioner training—remain significant, the field’s trajectory is bolstered by the emergence of novel care delivery models and robust policy initiatives. Ultimately, continued advancement is contingent upon a sustained commitment to empirical research and pedagogical excellence. Adhering to the World Health Organization’s (WHO) axiom that mental health is a foundational component of overall wellness, this integrative model underscores the inextricable link between somatic and psychological equilibrium. Urological clinicians are positioned as pivotal agents of change, uniquely situated to spearhead this transition through the diagnostic screening of psychiatric comorbidities, the promotion of prophylactic behavioral modifications, and the facilitation of multidisciplinary care pathways. This leadership mandate seeks to optimize clinical outcomes and establish a new paradigm of healthcare excellence by implementing a gender-stratified approach analogous to the gynecological framework within female reproductive health. By fully institutionalizing this integration, the urological community possesses the capacity to revolutionize the male health landscape, actualizing a future wherein the delivery of comprehensive, holistic care is the universal standard. RECOMMENDATIONS AND FUTURE RESEARCH 1. As the trajectory of urological clinical practice matures, the systemic assimilation of psychological services has emerged as a critical clinical imperative. The advancement of the discipline is predicated upon a synthesized framework that converges empirical research, legislative support, and pedagogical rigor to establish a benchmark for integrated care protocols. This shift toward a multidimensional patient management model necessitates interprofessional synergy across the healthcare continuum, ensuring that clinical interventions concurrently address both the somatic and affective dimensions of patient morbidity 2. Future empirical investigations must rigorously evaluate the therapeutic efficacy of integrated psychosocial and urological treatment modalities, prioritizing a longitudinal analysis of patient-centered clinical endpoints and the durability of psychological homeostasis. The elucidation of efficacious implementation frameworks coupled with a comprehensive delineation of systemic impediments across diverse clinical settings is foundational to the formulation of evidence-based clinical guidelines optimized for the multifaceted requirements of individuals presenting with complex urological pathologies. 3. Systemic legislative and institutional policy reforms are imperative to facilitate the seamless integration of these disparate clinical domains. The advocacy for the formal incorporation of psychiatric screening modalities and psychological interventions as requisite components of the urological clinical pathway complemented by the expansion of mental health curricula for urological specialists serves to establish the foundational infrastructure for a healthcare paradigm predicated upon holistic, multidisciplinary care models. 4. The implementation of pedagogical interventions designed to augment clinician literacy regarding the psychosocial sequelae of urological pathologies is a critical prerequisite for the delivery of holistic care. Furthermore, specialized training in advanced interpersonal communication and the institutionalization of multidisciplinary clinical cohorts will provide practitioners with the requisite competencies to address the heterogeneous needs of this patient population. 5. This multifaceted paradigm characterized by the convergence of empirical inquiry, legislative advocacy, and academic development is poised to optimize clinical outcomes and establish an unprecedented standard of care. Such a benchmark formalizes the integration of physiological and psychological health, fostering a healthcare environment defined by comprehensive, patient-centered clinical excellence. Page - 7Open Access, Volume 16 , 2026

Bashar Hadi Shalan Directive Publications Page - 8Open Access, Volume 16 , 2026 Conflict of Interest The authors declare no conflict of interest REFERENCES 1. Sitharthan, D. (2024). Psychological impact of urological disorders on men's mental health: the need for integrated support. Trends in Urology & Men's Health, 15(4), 7-12. 2. Anderson, D., Razzak, A. N., McDonald, M., Cao, D., Hasoon, J., Viswanath, O., ... & Urits, I. (2022). Mental health in urologic oncology.  Health psychology research, 10(3), 37518. 3. Anderson, D., Kumar, D., Divya, D., Zepeda, J. L., Razzak, A. N., Hasoon, J., ... & Urits, I. (2022). Mental health in non-oncologic urology patients.  Health Psychology Research, 10(3), 38352. 4. Klaassen, Z., & Wallis, C. J. (2020). Addressing mental health in urology patients: The time is now.  European Urology Focus, 6(6), 1137. 5. Matthew, A., & Elterman, D. (2014). Men’s mental health: Connection to urologic health.  Canadian Urological Association Journal, 8(7-8 Suppl 5), S153. 6. Anderson, D., Kumar, D., Divya, D., Zepeda, J. L., Razzak, A. N., Hasoon, J., ... & Urits, I. (2022). Mental health in non-oncologic urology patients.  Health Psychology Research, 10(3), 38352. 7. Chambers, Suzanne K., Jeff Dunn, Mark Lazenby, Samantha Clutton, Robert U. Newton, Prue Cormie, Anthony Lowe, David Sandoe, and Frank Gardiner. "ProsCare: A psychological care model for men with prostate cancer." (2013). 8. De Sousa, A., Sonavane, S., & Mehta, J. (2012). Psychological aspects of prostate cancer: a clinical review.  Prostate Cancer and Prostatic Diseases,  15(2), 120-127. 9. Bakalis, V., Papathanasiou, I. V., Malliarou, M., Fradelos, E. C., & Tzortzis, V. (2026). Impact of Prostatectomy on Quality of Life: A Comprehensive Study on Changes in Patients With Prostate Cancer. International Journal of Urological Nursing, 20(1), e70045. 10. Baker, P. (2017). Men's mental health: coming out of the closet?. Trends in Urology & Men's Health, 8(6), 19-22. 11. Whitrod, R. (1996). Improved quality of life for men with advanced prostate cancer: The need for an increased contribution by psychologists.  Australian Psychologist, 31(2), 127-132. 12. Gordon, N., Al-Salmi, O., Sweeney, M., Farooq, W., Sullivan, F., McDermott, R., ... & Galvin, D. (2025). Unmet sexual and psychological supportive care needs among prostate cancer patients in Ireland: findings from the IPCOR project. European Urology Open Science, 80, S6. 13. Althof, S. E., & Levine, S. B. (1997). Psychological Aspects of Erectile Dysfunction. In  Male infertility and sexual dysfunction (pp. 468-473). New York, NY: Springer New York. 14. Hanly, N., Mireskandari, S., & Juraskova, I. (2014). The struggle towards ‘the New Normal’: a qualitative insight into psychosexual adjustment to prostate cancer. BMC urology, 14(1), 56. 15. Hanly, N., Mireskandari, S., & Juraskova, I. (2014). The struggle towards ‘the New Normal’: a qualitative insight into psychosexual adjustment to prostate cancer. BMC urology, 14(1), 56. 16. Chambers, S. K., Chung, E., Wittert, G., & Hyde, M. K. (2017). Erectile dysfunction, masculinity, and psychosocial outcomes: a review of the experiences of men after prostate cancer treatment.  Translational andrology and urology, 6(1), 60. 17. Klaassen, Z., & Wallis, C. J. (2020). Addressing mental health in urology patients: The time is now.  European Urology Focus, 6(6), 1137. 18. Tovian, S. M. (2004). Urological disorders. 19. Sekar, R., & Gore, J. L. (2020). Integration of mental health metrics into patient-centered care of urology patients. European Urology Focus, 6(6), 1147-1149. 20. Charlick, M., Murphy, M., Murphy, B., Ettridge, K., O’Callaghan, M., Sara, S., ... & Beckmann, K. (2025). Sexual wellbeing support for men with prostate cancer: A qualitative study with patients. Translational Andrology and Urology, 14(4), 913-927. 21. Capogrosso, P., & Montorsi, F. (2016). Men's health and quality of life.  Current Opinion in Urology,  26(2), 121- 122.

Bashar Hadi Shalan Directive Publications Page - 9Open Access, Volume 16 , 2026 22. Watson, E., Shinkins, B., Frith, E., Neal, D., Hamdy, F., Walter, F., ... & Rose, P. (2016). Symptoms, unmet needs, psychological well-being and health status in survivors of prostate cancer: implications for redesigning follow- up. BJU international, 117(6B), E10-E19. 23. Punnen, S., Cowan, J. E., Dunn, L. B., Shumay, D. M., Carroll, P. R., & Cooperberg, M. R. (2013). A longitudinal study of anxiety, depression and distress as predictors of sexual and urinary quality of life in men with prostate cancer. BJU international, 112(2), E67-E75. 24. Someloo, S., Firoozi, M., Arabi, A., & Zaraj, H. (2025). A Systematic Review of Psychological Interventions for Patients with Prostate Cancer. Health Psychology, 14(53), 113-128. 25. Fritzsche, K., Diederich, D., & Schultze-Seemann, W. (2008). Psychooncology of prostate carcinoma- psychosocial distress and treatment approaches: a systematic review.  Zeitschrift fur Psychosomatische Medizin und Psychotherapie, 54(4), 329-353. 26. Orom, H., Biddle, C., Underwood, W., & Nelson, C. J. (2018). Worse urinary, sexual and bowel function cause emotional distress and vice versa in men treated for prostate cancer. The Journal of urology, 199(6), 1464-1469. 27. McInnis, M. (2018).  Life After Prostate Cancer: An Investigation of Patients' Health-Related Quality of Life, Sexual Outcomes, Mental Health, Social Support, and Healthcare Experiences (Doctoral dissertation, Queen's University at Kingston). 28. Kirby, R. S., & Kirby, M. (2005). The urologist as an advocate of men’s health: 10 suggested steps toward helping patients achieve better overall health.  Urology,  66(5), 52-56. 29. Sestini, A. J., & Pakenham, K. I. (2000). Cancer of the prostate: A biopsychosocial review.  Journal of Psychosocial Oncology, 18(1), 17-38. 30. Parahoo, K., McDonough, S., McCaughan, E., Noyes, J., Semple, C., Halstead, E. J., ... & Dahm, P. (2015). Psychosocial interventions for men with prostate cancer: a C ochrane systematic review.  BJU international,  116(2), 174-183. 31. Bobridge, A., Bond, M. J., Marshall, V., & Paterson, J. (2015). An investigation of the support needs of men and partners throughout the prostate cancer journey. Psycho-Oncology, 24(3), 341-347. 32. Matheson, L., Nayoan, J., Rivas, C., Brett, J., Wright, P., Butcher, H., ... & Wagland, R. (2020, May). A qualitative exploration of prostate cancer survivors experiencing psychological distress: loss of self, function, connection, and control. In Oncology Nursing Forum (Vol. 47, No. 3, pp. 318-330). Oncology Nursing Society. 33. Valcu, E. G., Firescu, D., Constantin, G. B., Rahnea-Nita, G., Rahnea-Nita, R. A., Șerban, C., & Rebegea, L. F. (2024). The integration of psychological intervention in the multimodal treatment of patients with prostate cancer and erectile dysfunction.  BRAIN. Broad Research in Artificial Intelligence and Neuroscience, 15(1), 498-515. 34. Talvitie, A. M., Ojala, H., Tammela, T., & Pietilä, I. (2024). Prostate cancer-related sexual dysfunction–the significance of social relations in men’s reconstructions of masculinity. Culture, Health & Sexuality, 26(6), 763-777. 35. Laws, T. A., & Esterman, A. J. (2015). The prostate cancer journey: results of an online survey of men and their partners. Cancer Nursing, 38(1), E1-E12. 36. Simkins, B. C. (2001).  A phenomenological study of the psychological impact of prostate cancer. Pacifica Graduate Institute. 37. Razzak, A. N., Orlando, N. A., Angelette, A., Kumar, V., Anderson, D. J., Hasoon, J., ... & Urits, I. (2022). Rare mental health disorders affecting urologic care: a comprehensive review.  Health Psychology Research, 10(4), 38674. 38. Levy, A., & Cartwright, T. (2015). Men’s strategies for preserving emotional well-being in advanced prostate cancer: An interpretative phenomenological analysis. Psychology & health, 30(10), 1164-1182. 39. Vartolomei, L., Shariat, S. F., & Vartolomei, M. D. (2018). Psychotherapeutic interventions targeting prostate cancer patients: a systematic review of the literature. European urology oncology, 1(4), 283-291. 40. Wareing, M. (2005). Lower urinary tract symptoms: a hermeneutic phenomenological study into men's lived experience. Journal of clinical nursing, 14(2), 239-246. 41. Krauss, D. J., Lantinga, L. J., & Kelly, C. M. (1990). In treating impotence, urology and sex therapy are complementary. Urology, 36(5), 467-470.

Bashar Hadi Shalan Directive Publications Page - 10Open Access, Volume 16 , 2026 42. Sheng, Z. (2021). Psychological consequences of erectile dysfunction.  Trends in Urology & Men's Health,  12(6), 19-22. 43. Tucker, S. R. (2015).  Uniting the body and mind in prostate cancer: A qualitative exploration of the psychosexual impact of prostate cancer treatment and related clinical communication needs. The University of Manchester (United Kingdom). 44. Omil-Lima, D., Thompson, A., Scarberry, K., & Crawshaw, B. (2024). Promoting the health of men of all backgrounds: educating ourselves to build trust and improve care. Nature Reviews Urology, 21(6), 323-324. 45. Bowen, E. (2019). A qualitative study of psychosexual implications of prostate cancer among Black prostate cancer survivors. J. Med. Res. Case Rep, 1, 1-8. 46. Mihalcia Ailene, D., Rahnea-Nita, G., Nechifor, A., Andronache, L. F., Dumitru, M. E., Rebegea, A. M., ... & Rebegea, L. F. (2025). Psychological Involvement in the Journey of a Patient with Localized Prostate Cancer— From Diagnosis to Treatment. Diseases, 13(10), 319. 47. Gore, J. L., Krupski, T., Kwan, L., Fink, A., & Litwin, M. S. (2005). Mental health of low income uninsured men with prostate cancer.  The Journal of urology,  173(4), 1323-1326. 48. Schueth, A. (2025). Opening up about cancer and mental health. Nature Reviews Urology, 22(4), 194-195. 49. Ervik, B., & Asplund, K. (2012). Dealing with a troublesome body: A qualitative interview study of men’s experiences living with prostate cancer treated with endocrine therapy. European Journal of Oncology Nursing, 16(2), 103-108.