Men often have “unrealistic expectations” about their sexual function after radical prostatectomy, according to a team of American and Turkish researchers.
Radical prostatectomy (removal of the prostate gland) is a common treatment for prostate cancer. It can be done openly or laparoscopically with the help of a robot.
Either surgical approach can lead to sexual complications, including erectile dysfunction (ED), weaker erections, climacturia (incontinence at orgasm), loss of penile length, and Peyronie’s disease.
Patients are not always clear about these potential issues and are surprised at their decline in sexual function as they recover.
In this study, the researchers worked with 336 men who underwent open radical prostatectomy (RP – 216 men) or robot-assisted laparoscopic prostatectomy. (RALP – 120 men). The men were seeking help with their sexual function about three months following surgery. Their mean age was 64 years. Over 80% of them were partnered.
Through a questionnaire, the participants provided information on their erectile function, ejaculation, orgasm, and penile morphology changes.
The survey revealed the following:
• Thirty-eight percent of the men could accurately recall their nerve-sparing status.
• Overall knowledge of sexual function after surgery was poor, especially for RALP patients. This group expected their erectile function to return more quickly, thought their function would return to pre-surgery levels, and were less likely to see the need for intracavernosal injection (ICI) therapy.
• Seventy percent of RP patients and 60% of RALP patients knew they could have anejaculation.
• Very few patients were aware of orgasm changes, climacturia, loss of penile length, and Peyronie’s disease.
The authors encouraged urologists to carefully consider patient education before prostatectomy. They noted that many factors might underlie provider-patient communication. Even if providers clearly explain sexual function after surgery, patients may not thoroughly take in this information because of the stressful impact of cancer. Offering written information may help.
“Indeed, we go one step further and encourage all clinicians to use written instructions to transmit sexual health information to patients, lest they receive the orally transmitted information in a state of anxiety, where failure to process the information may be highly likely,” they explained.
The study was first published online last month in BJUI International.
Resources
BJUI International
Deveci, Serkan, et al.
“A survey of patient expectations regarding sexual function following radical prostatectomy”
(Full-text. First published online: January 17, 2016)
http://onlinelibrary.wiley.com/doi/10.1111/bju.13398/full