Ten-year Outcomes of Sexual Function After Radical Prostatectomy: Results of a Prospective Longitudinal Study

Sivarajan, Ganesh; Prabhu, Vinay; Taksler, Glen B.; Laze, Juliana; Lepor, Herbert

doi:10.1016/j.eururo.2013.08.019

Cited by 74 publications

(37 citation statements)

References 30 publications

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“…48 Waiting for natural recovery of erections is difficult for patients and their partners, as recovery times are highly individual. 5 For example, for patients who undergo radical prostatectomy, even partial recovery of erectile function can take up to 4 years, owing to nerve recovery, 49 though the majority of function returns within the first 24 months. 39 Salonia et al 50 stipulate that patients should be told that recovery typically takes 6-36 months, but that the level of recovery at 6 months is predictive of long-term, overall recovery, as discussed by Vickers et al 39 To maintain sexual intimacy during that recovery period, patients and their partners should be encouraged to explore not just erectile assistance but also alternative sexual practices that are not erection-dependent.…”

Section: Foster Realistic Expectationsmentioning

confidence: 99%

“…3 Along with residual urinary incontinence, ED is the most persistent and debilitating patient-reported adverse effect of prostate cancer treatment. 4,5 ED is associated with significant declines in quality of life and has negative effects on psychological and marital adjustment for both patients 2,6,7 and their partners. 2,[7][8][9][10][11][12] About half of all patients will try a treatment for ED at some point after undergoing prostate cancer treatment.…”

Section: Introductionmentioning

confidence: 99%

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Psychosocial perspectives on sexual recovery after prostate cancer treatment

Walker¹,

Wassersug

Robinson³

2015

Nat Rev Urol

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Many therapies for erectile dysfunction (ED) after prostate cancer treatment improve erectile firmness, yet, most couples stop using aids within 1-2 years. Patients and partners who expect immediate and complete success with their first ED treatment can be demoralized when they experience treatment failure, which contributes to reticence to explore other ED aids. Comprehensive patient education should improve sustainability and satisfaction with ED treatments. Pre-emptive and realistic information should be provided to couples about the probability of recovering natural erections. Beginning intervention early and using a couple-based approach is ideal. Recommendations are provided about the timing of ED treatment, the order of aid introduction, and combination therapies. Renegotiation of sexual activity is an essential part of sexual adaptation. From the outset of therapy, couples should be encouraged to broaden their sexual repertoire, incorporate erection-independent sexual activities, and continue to be sexual despite ED and reduced libido.

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Section: Foster Realistic Expectationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Psychosocial perspectives on sexual recovery after prostate cancer treatment

Walker¹,

Wassersug

Robinson³

2015

Nat Rev Urol

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“…Radical prostatectomy (RP) is associated with a broad spectrum of adverse toxicities, of which erectile dysfunction (ED) is the most common, with a prevalence as high as 80% [1]. The pathophysiology of ED following RP involves both neuronal and vascular endothelial cell dysfunction, which, in combination, lead to impaired penile tissue oxygenation resulting in smooth muscle apoptosis, fibrosis, and veno-occlusion dysfunction [2].…”

mentioning

confidence: 99%

Effects of Nonlinear Aerobic Training on Erectile Dysfunction and Cardiovascular Function Following Radical Prostatectomy for Clinically Localized Prostate Cancer

et al. 2014

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Erectile dysfunction (ED) is a major adverse effect of radical prostatectomy (RP). We conducted a randomized controlled trial to examine the efficacy of aerobic training (AT) compared with usual care (UC) on ED prevalence in 50 men (n = 25 per group) after RP. AT consisted of five walking sessions per week at 55– 100% of peak oxygen uptake (VO2peak) for 30–60 min per session following a nonlinear prescription. The primary outcome was change in the prevalence of ED, as measured by the International Index of Erectile Function (IIEF), from baseline to 6 mo. Secondary outcomes were brachial artery flow–mediated dilation (FMD), VO2peak, cardiovascular (CV) risk profile (eg, lipid profile, body composition), and patient-reported outcomes (PROs). The prevalence of ED (IIEF score ≤21) decreased by 20% in the AT group and by 24% in the UC group (difference: p = 0.406). There were no significant between-group differences in any erectile function subscale (p > 0.05). Significant between-group differences were observed for changes in FMD and VO2peak, favoring AT. There were no group differences in other markers of CV risk profile or PROs. In summary, nonlinear AT does not improve ED in men with localized prostate cancer in the acute period following RP.

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“…Further studies conducted in Canada revealed similar findings where 15 SMM were given sexual health questionnaires after treatment for prostate cancer with prostatectomy or external beam radiotherapy finding that posttreatment sexual function related to anal intercourse may be better in the radiation groups compared to the surgical group [41]. The study did not indicate the point at which the former patients were given the questionnaire and this could impact on the reliability of this study as prostate cancer-associated problems can become worse over time due to delayed side-effects [42]. Both of these studies were small and as such their findings lack the corroboration of other SMM experiences or a lack of comparison with heterosexual men.…”

Section: Sexual Functionmentioning

confidence: 71%

Sexual minority experiences of cancer care: A systematic review

Hill

Holborn

2015

Journal of Cancer Policy

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a b s t r a c tThere is a lack of published evidence from within the UK examining the needs of LGB cancer patients. A full systematic review of the worldwide literature was carried out with the aim to ascertain the experiences of sexual minority cancer patients and identify specific needs required.Key databases were searched with a variety of terms relating to the sexual minority cancer experience. Suitable literature was reviewed and references within all articles were search to ensure as inclusive a review as possible. Articles were subject to critical appraisal and scoring using The Support Unit for Research Evidence (SURE 2013) critical appraisal tools to assess eligibility for inclusion within the review. Twenty-five articles were selected for inclusion and were analysed. The papers were categorised into the emerging themes from the literature: Experiences of care (n = 6), Coping and Wellbeing (n = 6), Emotional Support (n = 4), Body Image (n = 3), and Sexual Function (n = 6). The data extraction revealed contrasting views and experiences of LGB individuals' experience of cancer care. Lesbian and gay individuals have different perspectives of cancer care and needs from heterosexuals. Discriminatory attitudes were found to be present in many studies as well as inequalities and gaps within care and support.There is evidence that supports the development of sexual minority specific cancer support groups. Further research of sexual minorities affected by cancer in the UK should be carried out to increase the evidence base and better identify the needs in this cultural group.

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Ten-year Outcomes of Sexual Function After Radical Prostatectomy: Results of a Prospective Longitudinal Study

Cited by 74 publications

References 30 publications

Psychosocial perspectives on sexual recovery after prostate cancer treatment

Psychosocial perspectives on sexual recovery after prostate cancer treatment

Effects of Nonlinear Aerobic Training on Erectile Dysfunction and Cardiovascular Function Following Radical Prostatectomy for Clinically Localized Prostate Cancer

Sexual minority experiences of cancer care: A systematic review

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