title: Sexual function following radical prostatectomy: a prospective longitudinal study of cultural differences between Japanese and American men.
abstract: We conducted a cross-cultural comparison of the recovery of sexual function and bother during the first 2 years after radical prostatectomy (RP) between American and Japanese men. A total of 275 Japanese and 283 American men who underwent RP alone were prospectively enrolled into longitudinal cohort studies of health-related quality of life outcomes. Sexual function and bother (distress) were estimated with English and validated Japanese versions of the UCLA Prostate Cancer Index before RP and 1, 2-3, 4-6, 12, 18 and 24 months after RP. Each subject served as his own control. Japanese men reported lower sexual function scores at baseline, even after adjusted for age, prostate-specific antigen (PSA) and comorbidity (38 vs 61, P<0.001). The two groups had similar baseline sexual bother (70 vs 69, P=0.84). Japanese men had a smaller improvement in sexual function (beta=0.8 vs beta=5.3) and bother (beta=0.2 vs beta=2.9) over time than did the American men postoperatively, after adjusting for baseline score, age, baseline PSA and nerve-sparing. American men were more likely than Japanese men to regain their baseline sexual function by 24 months after surgery (hazard ratio (HR)=1.60; 95% confidence interval (CI)=1.06-2.42). In contrast, American men were less likely than Japanese men to return to baseline sexual bother (HR=0.57; 95% CI=0.44-0.75). This study demonstrates that Japanese and American men experience different patterns of recovery of their sexual function and bother after RP. Ethnicity may be a contributing factor.
authors.affiliation: Department of Urology, David Geffen School of Medicine, Los Angeles 90095-1738, CA, USA.
authors.forename: S
authors.initials: S
authors.lastname: Namiki
authors.forename: L
authors.initials: L
authors.lastname: Kwan
authors.forename: M
authors.initials: M
authors.lastname: Kagawa-Singer
authors.forename: T
authors.initials: T
authors.lastname: Tochigi
authors.forename: N
authors.initials: N
authors.lastname: Ioritani
authors.forename: A
authors.initials: A
authors.lastname: Terai
authors.forename: Y
authors.initials: Y
authors.lastname: Arai
authors.forename: M S
authors.initials: MS
authors.lastname: Litwin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003431:Cross-Cultural Comparison; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology; D006801:Humans; D007564:Japan; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods / Q000534:rehabilitation*; D012725:Sexual Behavior / Q000502:physiology*; D016896:Treatment Outcome; D014481:United States