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Francesco Pio Bizzarri1,2, Marco Campetella1, Salvatore Marco Recupero1

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Female sexual function after muscle-invasive bladder cancer treatment is impacted by radiotherapy more than surgery. Further research and standardized questionnaires are needed for better understanding and interventions for female sexual dysfunction (FSD).

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Area of Science:

  • Oncology
  • Urology
  • Sexual Health
  • Quality of Life Research

Background:

  • Female sexual function is a critical aspect of quality of life for women with muscle-invasive bladder cancer (MIBC) undergoing radical treatment.
  • Patient-centered care increasingly recognizes the importance of addressing sexual well-being in long-term cancer survivorship.
  • Understanding the impact of various MIBC treatments on female sexual function is essential for comprehensive patient management.

Purpose of the Study:

  • To systematically review and synthesize existing literature on the effects of radical treatments for MIBC on female sexual function.
  • To provide a comprehensive overview of oncological and functional outcomes related to sexual health in female MIBC patients.
  • To identify gaps in current research and propose future directions for improving the assessment and management of female sexual dysfunction (FSD).

Main Methods:

  • Systematic review of 29 qualitative and quantitative studies involving 1755 women treated for MIBC.
  • Inclusion criteria focused on studies addressing sexual function post-robot-assisted radical cystectomy (RARC) or open radical cystectomy (ORC).
  • Data extraction included treatment modalities (surgery, radiotherapy), urinary diversion types, and sexual function outcomes assessed via validated questionnaires.

Main Results:

  • Radiotherapy was associated with reduced sexual function, showing slightly better outcomes compared to surgery alone.
  • No significant differences in sexual outcomes were observed between robot-assisted radical cystectomy (RARC) and open radical cystectomy (ORC).
  • Various urinary diversion techniques were employed, including orthotopic neobladders and ileal conduits, with sexual function assessment using tools like FSFI and BCI.

Conclusions:

  • Qualitative research is crucial to deeply understand the lived experiences of female sexual dysfunction (FSD) post-MIBC treatment.
  • Developing tailored interventions requires integrating both patient and clinician perspectives.
  • Standardizing questionnaires for FSD assessment is vital for improving study comparability and ensuring consistent evaluation of treatment effects.