Internet Access, Health-Related Internet Use, and Pelvic Floor Muscle Exercise Adherence Among Prostate Cancer Patients With Urinary Incontinence After Radical Prostatectomy: A Cross-Sectional Study

BACKGROUND: Pelvic floor muscle exercise (PFME) is the primary conservative management for urinary incontinence following radical prostatectomy. While digital health resources are increasing, the specific impact of health-related internet use on PFME adherence remains poorly understood. OBJECTIVE: To examine the associations between internet access, health-related internet use frequency, and PFME adherence among prostate cancer survivors. METHODS: A cross-sectional survey (N = 251) was conducted between October and December 2025. Data on internet access, health-related internet use, and PFME adherence were analyzed using ordinal logistic regression and restricted cubic splines, with sequential adjustment for sociodemographic and clinical factors. RESULTS: Health-related internet use was independently associated with PFME frequency (OR = 1.46; 95% CI, 1.03-2.06), whereas mere internet access was not. A significant nonlinear relationship was observed between health-related internet use and exercise frequency (P for nonlinear = .025), while exercise duration demonstrated a linear association. Effects were more pronounced among participants with lower educational attainment or lower baseline physical activity. CONCLUSIONS: Health-related internet use, rather than simple internet access, is a key independent predictor of PFME adherence. These findings suggest that digital engagement significantly facilitates self-management behaviors during postsurgical recovery. IMPLICATIONS FOR ONCOLOGY NURSING PRACTICE: Oncology nurses should assess patients' health-related internet use patterns and digital literacy rather than just internet access to identify those requiring additional navigation support. Tailored digital health resources should be integrated into survivorship care, particularly for patients with lower educational backgrounds, to bridge adherence gaps and reduce health disparities.