Determinants of Sexual Satisfaction in Men with Prostate Cancer

Abstract

Objective There is a growing debate about the important determinants of sexual satisfaction in men. Some authors argue that men's sexual satisfaction correlates with physical functioning variables such as erection quality and ejaculatory time. Other authors have suggested that the limited literature indicates that men's sexual satisfaction is related to psychosocial variables such as relationship satisfaction, depression, or anxiety. This study is the first to our knowledge to explore this question in men with prostate cancer. Materials and Methods This archival, cross-sectional research analyzed quality-of-life, depression, and anxiety data on 352 men with early- and late-stage prostate cancer. Questions from the Functional Assessment of Cancer Therapy Scale-Prostate Cancer Version were used to assess sexual satisfaction, erectile function, and relationship closeness. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression. Results In general, the subjects reported low sexual satisfaction with a mean score of 2.3 on a 5-point Likert scale (1–5). In the correlational analyses, arthritis, brachytherapy, and depression/anxiety were all negatively associated with sexual satisfaction, while erectile function and relationship closeness were positively associated with sexual satisfaction (P < 0.05). In the subsequent multivariate analysis, erectile function (P < 0.01), relationship closeness (P < 0.05), and depression/anxiety (P < 0.05) remained significant predictors of sexual satisfaction. In this model, erectile functioning produced the largest effect (beta = 0.57) as compared to relationship closeness and depression/anxiety (beta values approximately 0.11). Conclusions In this sample of men with prostate cancer, both physical and psychosocial variables were found to be important determinants of sexual satisfaction. Erectile function appears to have the strongest association with sexual satisfaction; however, variables such as relationship quality, depression, and anxiety are also clearly related to a satisfying sex life in this sample.

Erectile dysfunction and sexual health after radical prostatectomy: impact of sexual motivation

“…5 To improve patients' and their partners' sex-lives, it is thus necessary not only to treat the mechanics (ED treatment), but also to provide appropriate psychological or sexual counseling to help cope with the impact of RP on sexual desire and orgasm. 6,28 In our study, the patients who were most motivated to remain sexually active after RP (Group 1) experienced a greater degree of bother and had a lower overall sexual satisfaction score than the less motivated patients. Their satisfaction score was very low (0.5/10) when they were not receiving ED treatment but higher on treatment (3.9/10), thus confirming the benefit of treatment in motivated patients.…”

The psychosocial aspects of sexual recovery after prostate cancer treatment

“…Men's infrequent pursuit of erectogenic help suggests that other factors in sexual recovery may have a significant role. Psychosocial aspects of sexual recovery are cited in some studies 3,29 and offer an opportunity to examine the context of erectile recovery.…”

“…Interestingly, this sexual response echoes Basson's 74 model of the female sexual response in which the appraisal of context and subjective interest in sexual activity are the more critical variables than visual stimuli and genital congestion. Our need to explore men's sexuality more fully after prostate cancer treatment is highlighted by a recent study by Nelson et al, 29 which identifies both erectile functioning and psychosocial factors as determinants of sexual satisfaction.…”

Psychological aspects of prostate cancer: a clinical review

“…48 Preliminary data exist to support these clinical observations; studies have found that the couples where the male partner reported ED also reported less intimate contact, and lower scores on togetherness and tenderness within the relationship. 49 Careful consideration and good history taking are a must when determining combined urological and psychological approaches for the management of ED in these cases.…”