A multimodal approach to sexual function after allogeneic hematopoietic stem cell transplantation: a randomized...

Sexual dysfunction is a frequent long-term complication following allogeneic hematopoietic stem cell transplantation (HSCT). This multicenter, prospective, randomized controlled trial evaluated the feasibility and efficacy of a multimodal intervention targeting sexual function and early detection of genital chronic graft-versus-host disease (cGVHD) in adult recipients of HSCT. Participants were randomized 1:1 to the intervention or usual care. The intervention included repeated questionnaires, genital assessments, and nurse-led consultations. Sexual function was assessed using the Female Sexual Function Index or the International Index of Erectile Function, with secondary outcomes including sexual health, sexual distress, and feasibility measures. Overall sexual function did not differ significantly between groups for women (difference (diff) 3.3, P = 0.391) or men (diff 0.9, P = 0.761). Significant improvements favoring the intervention group were observed in women's sexual pain (diff -2.1, P = 0.019) and, for both sexes, in sexual pain (diff -13.6, P = 0.030), communication with professionals (diff -15.5, P = 0.017), and partnership quality (diff -22.8, P = 0.040). The incidence of genital cGVHD was 25.0% among male (n = 11) and 28.1% (n = 9) among females. We conclude that the multimodal intervention was feasible, led to improved sexual health, and facilitated earlier recognition of genital cGVHD, supporting the integration of interdisciplinary sexual health assessments into routine post-HSCT care.