Determinants of sexual satisfaction in men with prostate cancer.
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.


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.
Nelson
Christian J
CJ
Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY 10022, USA. nelsonc@mskcc.org
Choi
Judy M
JM
Mulhall
John P
JP
Roth
Andrew J
AJ
D000368:Aged; D001007:Anxiety / Q000209:etiology; D003863:Depression / Q000209:etiology; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology*; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000523:psychology*; D011788:Quality of Life; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D011795:Surveys and Questionnaires