Sexual distress in patients after radical cystectomy for bladder cancer: a qualitative study

Although sexual health is recognized as a fundamental component of well-being, it may be a neglected aspect of care within the context of patients after radical cystectomy, which examines the perception of sexual distress as a result of undergoing radical cystectomy, which helps inform healthcare service providers.

This study employed a methodological integration of grounded theory (GT) and phenomenology. We selected two tertiary hospitals that assisted in the recruitment process. An interview advisory committee was established to guide the research design and using a data form for documenting persona characteristics as well as a semi-structured interview. With maximum differentiated sampling based on the grading of the Index of Sexual Satisfaction (ISS), which allowed for a comprehensive understanding of sexual distress, 15 patients were included, 10 were in the high-scoring subgroup, and 5 were in the low-scoring subgroup. The Consolidated Criteria for Reporting Qualitative Research (COREQ) were used to ensure a consistent process throughout the study.

A total of four themes and 14 sub-themes were distilled: significant symptoms of sexual distress (sexual dysfunction and interruption of sexual intercourse), negative emotional dilemmas (reduced self-esteem and self-confidence, anxiety and depression, and fear and avoidance of sexual life), multiple changes in marital relationships (decreased intimacy, communication barriers, role change of husbands and wives, and partner's understanding and support), positive coping styles, and the need for sexual rehabilitation (active seeking for medical help, trying alternatives, psychological adjustment, facing problems with the partner and redefining intimate relationships, and looking forward to professional guidance for sexual distress).

The sexual life of patients after radical cystectomy faces multiple problems, which suggests that healthcare professionals should pay attention to the sexual health needs of patients, including partners in the rehabilitation process, and work together with sex therapists and psychological counselors to formulate individualized sexual rehabilitation programs to improve the quality of their sexual lives. Therefore, screening for sexual problems and providing counseling services for patients after radical cystectomy care planning are recommended.