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Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Sexual bother following radical prostatectomyjsm
Christian J Nelson1, Serkan Deveci, Jason Stasi
1Department of Psychiatry and Behavioral Sciences--Memorial Sloan-Kettering Cancer Center, NY 10021, USA. nelsonc@mskcc.org
The Journal of Sexual Medicine
|January 28, 2010
Summary
Sexual bother significantly increases after radical prostatectomy (RP), impacting men even with good erections. Men do not psychologically adjust to erectile dysfunction (ED), necessitating early evaluation and support.
Area of Science:
- Urology
- Oncology
- Sexual Health
Background:
- Conflicting literature exists regarding sexual bother in prostate cancer patients post-treatment.
- Some studies report high sexual bother from erectile dysfunction (ED) after prostate cancer treatments, while others suggest treatment benefits may outweigh ED concerns.
Purpose of the Study:
- To assess the change in sexual bother (SB) following radical prostatectomy (RP).
- To determine if men psychologically adjust to diminished erectile function (EF) post-RP.
- To identify baseline predictors of post-RP sexual bother.
Main Methods:
- 183 men undergoing RP completed the Erectile Function Domain (EFD) and Sexual Bother (SB) questionnaires preoperatively and at 12 and 24 months postoperatively.
- Statistical analyses included repeated-measures ANOVA and linear multiple regression.
Main Results:
- Mean EFD scores decreased significantly from baseline to 24 months post-RP (24.8 to 16.7, P < 0.01).
- Mean SB scores increased from baseline to 12 months (4.3 to 6.7, P < 0.01) and remained stable through 24 months (6.3, P = ns).
- Only 7% of men with ED reported reduced bother at 24 months; no significant baseline predictors of SB were identified, with change in EFD being the sole predictor.
Conclusions:
- Sexual bother escalates post-RP, affecting men irrespective of postoperative erection quality, and encompasses shame, embarrassment, and reduced life happiness.
- Men do not appear to psychologically adjust to ED after RP.
- Early referral or evaluation for sexual dysfunction is recommended for this patient population.
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