Improvement in sexual function after robot-assisted radical prostatectomy: A rehabilitation program with involvement of a clinical sexologist

Ljunggren, C. A.; Ströberg, Peter

doi:10.5173/ceju.2015.484

Cited by 12 publications

(14 citation statements)

References 33 publications

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“…In our experience, during the COVID-19 pandemic, a lot of patients refused recommended sexual rehabilitation protocols. The missed or late sexual rehabilitation will possibly have an influence on future sexual function [ 14 ]. Moreover, sexual activity is considered by patients to a lesser degree because sexual needs are composed of a biological, psychological and social component [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Preliminary evidences of the impact of social distancing on psychological status and functional outcomes of patients who underwent robot-assisted radical prostatectomy

2020

Cent european J Urol

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Introduction Social distancing is considered the best strategy to prevent the spread of COVID-19 (COronaVIrus Disease 19). We aimed to analyse the effect of ‘social distancing’ on the emotional state, post-operative pain and functional outcomes of patients undergoing robot-assisted radical prostatectomy (RARP). Material and methods We retrospectively reviewed data of male patients who underwent RARP within the study period (from March to April 2019 [Group A = 27 patients] and from March to April 2020 [Group B = 29 patients]). Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) results were collected on the first day of hospitalization. Post-operative pain was assessed using the numerical rating scale (NRS) and visual analogic scale (VAS) after surgery in the post-anesthesia care unit (PACU) and at 24 hours. Functional outcomes were evaluated at the one-month follow-up. Demographic, pathological and peri-operative data were collected for all patients. Results There were no significant differences in demographics and pathological characteristics amongst the groups. We observed that patients in Group A had a statistically lower value on the PHQ-9 and GAD-7 questionnaires than patients of Group B. Moreover, Group A showed statistically significant better post-operative pain control in PACU and at 24 hours. At one-month follow-up, patients in Group B required more diapers for incontinence than Group A, showing poor early continence. Patients in Group A showed interest in sexual rehabilitation after 1.11 ±.320 months while patients in Group B after 2.59 ±.712 months (p <.001). Moreover, 17 out of 29 patients (58.62%) in Group B were referred to an andrologist, compared to 100% of patients from Group A (p = 0.0006). Conclusions Social distancing during the COVID-19 pandemic is associated with a poor pre-operative emotional state, as well as influencing post-operative pain, early urinary continence and desire for sexual rehabilitation.

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Section: Discussionmentioning

confidence: 99%

Preliminary evidences of the impact of social distancing on psychological status and functional outcomes of patients who underwent robot-assisted radical prostatectomy

2020

Cent european J Urol

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“…Nevertheless, it appears that increased sexual rehabilitation efforts postoperatively improve a patient’s ability to have penetrating sexual activity one year after dVRP, with or without a nerve sparing procedure [ 19 ], and the long-term results are sustainable. Stopping sexual activity over time appears to be more related to co-morbidities, aging and change of marital status.…”

Section: Discussionmentioning

confidence: 99%

“…A previous study [ 19 ] reported on the positive outcome of a combined penile and sexual medicine rehabilitation program, including a clinical sexologist (CS) into the rehabilitation process, with the aim of restoring a good sexual life postoperatively for all men that were preoperatively fully potent, regardless of whether the NVB was preserved or not ( Figure 1 ). This study did not address if these patients would discontinue their sexual activity over time as patients with ED treatment alone do.…”

Section: Introductionmentioning

confidence: 99%

Sustainable long-term results on postoperative sexual activity after radical prostatectomy when a clinical sexologist is included in the sexual rehabilitation process. A retrospective study on 7 years postoperative outcome

Ströberg

Ljunggren²,

Sherif

2020

Cent european J Urol

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Introduction The aim of this study was to perform a retrospective evaluation of 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 whether preservation of the neurovascular bundles was performed or not. Material and methods The study included 79 preoperatively potent and sexually active patients (aged 45–74 years, mean 61) that had undergone a dVRP due to localized prostate cancer and during the 1 st postoperative year participated in a combined penile and sexual rehabilitation program involving a CS. The subjects were followed up with the same interview and questionnaires at approximately 1, 3 and 7 years postoperatively. The interview and questionnaires addressed erectile function (EF), erectile dysfunction (ED) treatment, frequency of penetrating sexual activity, patient’s perceptions of sexual life (LISAT-8). Results One year postoperatively, 84% of patients were sexually active with penetrating sex, 15% with unassisted normal erections. 45% found their postoperative sexual life satisfactory (LISAT-8, question #6). Three years postoperatively, 76 patients were evaluable, 73% were sexually active with penetrating sex, 19% with unassisted normal erections. Furthermore, 56% of patients found their postoperative sexual life to be satisfactory. Seven years postoperatively, 74 patients were evaluable, 74% were sexually active with penetrating sex, 44% with unassisted normal erections. A total of 59% of patients found their postoperative sexual life to be satisfactory. The reasons for not having penetrating sex were diverse. Conclusions Involvement of a CS in a postoperative combined penile and sexual rehabilitation program appears to improve the possibility of an acceptable sexual life and function one year after surgery. These results appear to be sustainable in the long-term.

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“…Erectile recovery should not only be focused on penile function, but also aimed to establish a satisfactory and healthy sexual life for both the patient and their partners, regardless of whether there is complete restoration of spontaneous EF. Some researchers have suggested that the application of behavioral science methods and tools by a clinical sexologist, in addition to the standard medical/surgical EF care, can improve the ability to have regular sexual activity with penetrating sex in patients undergoing robotic RP ( 67 , 68 ). Although there is a controversy in the effectiveness of penile rehabilitation modalities, any rehabilitation is undeniably better than no action at all.…”

Section: Discussionmentioning

confidence: 99%

The controversy surrounding penile rehabilitation after radical prostatectomy

Clavell-Hernández¹,

Wang²

2017

Transl. Androl. Urol.

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Radical prostatectomy (RP) techniques have been refined in the last few decades. Despite nerve-sparing surgery, erectile dysfunction (ED) still seems to be affecting more than half of patients undergoing RP. Penile rehabilitation consists of understanding the mechanisms that affect erectile function (EF) and utilizing pharmacologic agents, devices or interventions to promote male sexual function before and after any insult to the penile erectile physiologic axis. There currently is a limited amount of clinical trials that assess treatments with the goal of recovering post-prostatectomy EF. The goal of this article is to assess a contemporary series of trials that study penile rehabilitation. Although the current evidence lacks to prove its irrefutable effectiveness, advancements in research and technology forecast a promising future in penile rehabilitation management.

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Improvement in sexual function after robot-assisted radical prostatectomy: A rehabilitation program with involvement of a clinical sexologist

Cited by 12 publications

References 33 publications

Preliminary evidences of the impact of social distancing on psychological status and functional outcomes of patients who underwent robot-assisted radical prostatectomy

Preliminary evidences of the impact of social distancing on psychological status and functional outcomes of patients who underwent robot-assisted radical prostatectomy

Sustainable long-term results on postoperative sexual activity after radical prostatectomy when a clinical sexologist is included in the sexual rehabilitation process. A retrospective study on 7 years postoperative outcome

The controversy surrounding penile rehabilitation after radical prostatectomy

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