title: Altered male physiologic function after surgery for prostate cancer: couple perspective.
abstract: OBJECTIVE
  Both the diagnosis of prostate cancer (PCa) and the physiologic outcomes of surgical treatment impact the male's psychological sphere. However, current research advocates a refocusing of outcomes directed to the PCa "couple". Herein we acquire insight into perspective and concordance regarding male physiological function from the standpoint of a couple recovering from PCa surgery.
  
  
  METHODS
  Couples whereby the male partner had undergone primary surgical treatment for PCa were mailed a Retrospective Sexual Survey (RSS) packet consisting of male and female partner questionnaires. RSS questions surveyed physiological changes in libido, foreplay, erection and arousal, orgasm and ejaculation in addition to perceived psychological impact. Patients' and partners' scores were evaluated to determine the concordance of both individual items as well as domain sums.
  
  
  RESULTS
  Twenty-eight couples completed the questionnaires. Only about 40% of men and women were happy with their levels of sexual interest with 82% concordance. Urine loss during orgasm was reported by 43% of men; the majority of participants were bothered by it. Ejaculation changes were observed by 96% of men (concordance 96%) with most reporting anejaculation. A change in orgasm experience was noted by 86% of men (and 36% of their female partners, p < 0.0001). Despite the change, the majority of men and women reported being satisfied with their ability to climax.
  
  
  CONCLUSIONS
  Our results indicate that patients and their female partners may interpret differently the same physiological outcomes of PCa surgery. This information could be useful to better counsel the PCa couple and help patients and partners adjust after surgery.
authors.affiliation: Division of Urology, Department of Surgery and Duke Prostate Center, Duke University Medical Center, Durham, North Carolina 27710 , USA. matvey.tsivian@duke.edu
authors.forename: Matvey
authors.initials: M
authors.lastname: Tsivian
authors.forename: Janice M
authors.initials: JM
authors.lastname: Mayes
authors.forename: Tracey L
authors.initials: TL
authors.lastname: Krupski
authors.forename: Vladimir
authors.initials: V
authors.lastname: Mouraviev
authors.forename: Craig F
authors.initials: CF
authors.lastname: Donatucci
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Polascik
mesh_terms: D000368:Aged; D003075:Coitus / Q000502:physiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000523:psychology / Q000601:surgery*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology* / Q000523:psychology; D018454:Spouses / Q000523:psychology*; D011795:Surveys and Questionnaires