Do Austrian enterostoma- and continence consultants integrate sexual health problems in daily routine - self-assessment results at the annual meeting of the Austrian enterostoma and continence consultants, October 2017, Linz, Austria
Buchner-Jirka, K1; Ucsnik, L2; Kottmel, A3; Körbel, TH4; Bitzer, J5; Wunderlich, M6; Teleky, B7
1: Public Hospital Vöcklabruck, Gespag, Austria, Austrian Society für Continence and Stoma-Therapy; 2: Medical University Vienna, Univ.Clin f. Surgery, Austria; 3: Private Practise for Gynecology and Sexual Medicine, Austria; 4: Medical University, Austria; 5: Private Practise, Swiss; 6: Private Practise, Austria, Austrian Society for Continence; 7: Medical University Vienna, Univ.Clin f. Surgery, President of the European Federration for ColoRectal Cancer
Introduction: Troubled continence (stuhl, urine) and need for stoma-therapy are well-known to have an impact on sexual function, social engagement and thus quality of patients’ life. Little is scientifically known in the field of stoma-therapy and continence consultants’ contribution to and impact on patient’s sexual recovery. Thus we asked representatives to self-assess the integration of sexuality in stoma- and continence-consultation.
Method: At the annual meeting of Austrian stoma-therapy and continence consultants association, Linz, October 2017, 32 of 109 questionnaires were answered and returned (return rate 39,4%).
Results: 86% of the consultants were female, 33% aged 41-50 years, 28% 51-60 years, 44% with clinical experience of more than 20 years. 7% had sexual medicine training. 37% of the participants asked up to 20% of the patients about sexual health issues. 74% of the participants were asked by up to 20% the patients about sexual problems. 37% of the consultants suggested sexual health issues in the patients without addressing them. The reasons why patients did not ask about their troubled sexuality were evaluated by the experts: other topics more important (60%), lack of time (42), language barrier (35%), patient’s age (28%), patient’s culture (26). Settings to actively address sexual problems were rated: before and after surgery (60% each), andro-/menopause (58%), control examination, rehabilitation (42% each), pain therapy (30%). The specialists they cooperated with and referred to were: urologists (44%), gynecologists (40%), andrologists (35%), sexual medicine (26%), psychotherapists (21%). The support offered by the consultants were: information on the physiology of sexual function (reference to specialists (30% each). 40% assessed lacking professional sexual medicine knowledge and skills in order to increase continence and enterostomata consultation’s success.
Conclusion: 80% of the patients with impaired continence and social life, thus quality of life, did not ask their consultants which doesn’t mean they didn’t have issues. 80% were not asked by the consultants. 60% of the participants stated before and after surgery troubled sexuality should be addressed, but only 7% of them had sexual medicine expertise. There’s a need for specific training-concepts for stoma-therapy and continence consultants in order to address and consult sexual health issues, too. Further scientific investigations are indicated in this key-field linking surgery, gynecology, urology and physical medicine as well as rehabilitation.
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