Altered male physiologic function after surgery for prostate cancer: couple perspective

Abstract

Purpose: Both the diagnosis of prostate cancer (PCa) and the physiologic outcomes of surgical treatment impact the male's psychological sphere. However, current research advocates a refocusing of outcomes directed to the PCa "couple". Herein we acquire insight into perspective and concordance regarding male physiological function from the standpoint of a couple recovering from PCa surgery. Materials and Methods: Couples whereby the male partner had undergone primary surgical treatment for PCa were mailed a Retrospective Sexual Survey (RSS) packet consisting of male and female partner questionnaires. RSS questions surveyed physiological changes in libido, foreplay, erection and arousal, orgasm and ejaculation in addition to perceived psychological impact. Patients' and partners' scores were evaluated to determine the concordance of both individual items as well as domain sums. Results: Twenty-eight couples completed the questionnaires. Only about 40% of men and women were happy with their levels of sexual interest with 82% concordance. Urine loss during orgasm was reported by 43% of men; the majority of participants were bothered by it. Ejaculation changes were observed by 96% of men (concordance 96%) with most reporting anejaculation. A change in orgasm experience was noted by 86% of men (and 36% of their female partners, p < 0.0001). Despite the change, the majority of men and women reported being satisfied with their ability to climax. Conclusion: Our results indicate that patients and their female partners may interpret differently the same physiological outcomes of PCa surgery. This information could be useful to better counsel the PCa couple and help patients and partners adjust after surgery.

Oncological and functional outcomes following open radical prostatectomy: how patients may achieve the "trifecta"?

“…Patient and couple counseling needs to done according to evidenced-based facts using preoperative and postoperative parameters (15). In multivariate analysis, age, pathologic GS, pathologic stage, specimen weight and NS procedure were independent factors affecting Trifecta.…”

A systematic review of the correlates and management of nonpremature ejaculatory dysfunction in heterosexual men

“…The majority of patients were bothered by the problem [Tsivian et al 2009]. Nearly 2 years following radical prostatectomy, 21% of patients reported that climacturia occurred most of the time or always, 48% reported that it caused significant bother and 21% thought that it was of significant bother to their partners [Lee et al 2006].…”

Sexual Dysfunction Following Radical Prostatectomy

“…The psychological consequences of RP have garnered little attention compared with ED. Dealing with the diagnosis of cancer and recovering from surgery have negative impacts on QoL, sexual desire, and function after RP (Tsivian et al, 2009). A prospective study evaluated the mental health of 236 patients following RP using questionnaires about health‐related QoL preoperatively and compared the results with QoL at 3, 6, and 12 months postoperatively (Treiyer et al, 2011).…”

“…Orgasmic dysfunction is another lesser recognized sexual consequence of RP, and it has a significant impact on QoL after RP. Because the prostate is removed, along with the seminal vesicles, and the vas deferens are divided during RP, this procedure inevitably results in loss of ejaculation (Magelssen et al, 2006; Tsivian et al, 2009). Most men are not overly bothered by absence of ejaculation, but it has been noted that this absence may interfere with an individual's sexual satisfaction (Tsivian et al, 2009).…”