Sexuality in patients undergone surgery for urological cancers
Ladegaard, PBJ1; Haahr, M1; Lund, L1
1: Department of Urology, Odense University Hospital, Denmark
Objective; Our objective is to analyze the outcome of various sexuality parameters in patients’ after radical prostatectomy (RP), radical nephrectomy (RN) in both sex and radical cystectomy (RC) in women.
Materials and methods; This retrospective study is a summary of sexuality in patients undergone surgery of urological cancers in a University Hospital covering 1.8 mill people. RP was investigated by examination of the records, RN by a questionnaire and focus interview and RC by a questionnaire. Records of 1127 men undergone RP between 2003 and 2014 were reviewed 12-month post-operatively. 704 patients were eligible for final analysis. Sexual recovery was defined as self-reported erection sufficient for intercourse (ESI). 310 patients, both sex, undergone a nephrectomy from 2010 to 2015 were identified. 226 patients were eligible for final analysis. 85 female patients were identified undergone RC from 1997 to 2014. 54 patients were eligible for final analysis. Outcome in sexuality were measured by validated questionnaires and interviews to assess the consequences of sexual function after radical surgery. All patients were identified by usage of diagnosis and hospital codes.
Results; RS: Only 226 (32%) reported ESI with or without erectile aids (EA). About half (48%) required EA. Erectile dysfunction (ED) was reported by 478 (68%) men: in a quarter (25%) of cases despite use of EA. Surprisingly, the proportion of ESI was almost the same in patients with nerve-sparing (36%) compared to non-nerve-sparing RP (30%). RN: A total response rate of 68,1% (95 men and 59 women) was found. 56 (59%) of responding men reported some degree of ED. 100 (65%) participants were worried about their future sexual life. The difference in observed sexual relations were for both genders significant post-operatively compared to pre-operative state (P < 0,0001). Only 10% of the participants reported sufficient information about sexual consequences prior to RN. RC: Among 54 patients, 47 (88%) replied. 25 (46%) questionnaires were filled out. A total of 22 (88%) of responding participants were not sexually active post-operatively. A significant part of the women reported low sexual contact (88%) and little interest in close physical contact (48%).
Conclusion; Sexual consequences after operation for urological cancers are enormous. This study showed insufficient preoperative information regarding sexual relations. There is a need for further studies to elaborate both physiological and psychological issues pre- and post-operatively.
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