Sustainable longterm results in sexual function and activity after prostate cancer surgery, using a postoperative rehabilitation program with involvement of a clinical sexologist. A seven year follow-up
Ljunggren, C1; Stroberg, P2; Helen, I1
1: Deptarment of Urology,Ryhov County Hospital, Sweden; 2: Department of Urology,Umeå university Hospital, Umea, Sweden
Objective: To evaluate long term sustainability of a postoperative combined penile and sexual rehabilitation program involving a clinical sexologist(CS) for preoperative fully potent men undergoing daVinci Robotic Radical Prostatectomy (dVRP) regardless of preservation of the neurovascular bundles or not.
Material and methods: 79 preoperatively potent and sexually active patients (ages 45-74 years mean 61) that had a dVRP due localized Prostate cancer and during the 1st postoperative year participated in a combined penile and sexual rehabilitation program involving a CS with the aim to improve the postoperative outcome on erectile function, sexual activity and satisfaction, regardless of nerve sparing procedure or not. The subjects were followed-up at approximately 3 and 7 years postoperatively with the same combined telephone interview and questionnaires as at the end of the rehabilitation program 1 year postoperatively. The interview and questionnaires addressed Erectile Function(EF), Erectile Dysfunction(ED) treatment, frequency of penetrating sexual activity, patient’s perceptions of sexual life postoperatively as compared preoperatively LiSAT 8 question # 6 sexual life, marital status, reasons for not being sexually active postoperatively.
Results: At baseline one year postoperatively 84% were sexually active with penetrating sex, 15% with unassisted normal erections. 45% found their postoperative sexual life satisfactory (LiSAT 8 q #6). At 3 years postoperatively 76 patients were evaluable, 73% were sexually active with penetrating sex, 16% with unassisted normal erections. 56% found their postoperative sexual life satisfactory (LiSAT 8 q #6). At 7 years postoperatively 74 patients were evaluable, 74% were sexually active with penetrating sex, 32% with unassisted normal erections. 59% found their postoperative sexual life satisfactory (LiSAT 8 q #6). Reasons for not having penetrating sex was diversified, lack of interest from patient or partner, side effects or lack of efficacy of ED treatment, tumor progression, concomitant diseases and change of marital status.
Conclusion: Involvement of clinical sexologist in a postoperative combined penile and sexual rehabilitation program after radical da Vinci robotic prostatectomy appears to improve the possibility of an acceptable sexual life and function one year after surgery, and these results appear to be sustainable over longtime after the surgery.
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