Sexual bother following radical prostatectomyjsm.
BACKGROUND
The literature on sexual bother in men with prostate cancer is conflicting. While some data indicate high bother from erectile dysfunction (ED) following prostate cancer treatments, other results suggest the life-saving nature of the treatment may mitigate ED concern.


OBJECTIVE
(i) To determine if sexual bother increases post radical prostatectomy (RP); (ii) To determine if men psychologically adjust to diminished erections; (iii) To identify baseline predictors of post-RP sexual bother.


METHODS
We identified 183 men treated with RP who completed inventories including Erectile Function Domain (EFD) and Sexual Bother (SB) preoperatively and at 12 and 24 months postoperatively. Statistical analyses included repeated-measures analysis of variance and linear multiple regression.


METHODS
The EFD of the International Index of Erectile Function and the SB subscale from the Prostate-Health Related Quality-of-Life Questionnaire.


RESULTS
The mean age of the sample was 58 +/- 7 years. The mean EFD scores decreased from baseline to the 24-month time point (24.8 vs. 16.7, P < 0.01). The mean SB scores increased from baseline to the 12 month time point (4.3 vs. 6.7, P < 0.01), and remained stable from the 12 month to 24 month time points (6.7 vs. 6.3, P = not significant [ns]). This was true for men with ED (EFD < 24) and without ED. Only 7% of men with ED moved from being "bothered" at 12 months to "no bother" at 24 months. There were no significant baseline predictors of sexual bother; baseline variables tested were: age, race, marital status, prostate-specific antigen (PSA) value, EFD, sexual desire, and intercourse satisfaction. The change in EFD scores was the only significant predictor of SB scores.


CONCLUSIONS
Sexual bother increases post-RP, even in men with "good" erections postoperatively, and includes shame, embarrassment, and a reduction in general life happiness. Because men do not seem to "adjust" to ED, referral or evaluation should occur early in this population.
Nelson
Christian J
CJ
Department of Psychiatry and Behavioral Sciences--Memorial Sloan-Kettering Cancer Center, NY 10021, USA. nelsonc@mskcc.org
Deveci
Serkan
S
Stasi
Jason
J
Scardino
Peter T
PT
Mulhall
John P
JP
D000223:Adaptation, Psychological; D000368:Aged; D007172:Erectile Dysfunction / Q000523:psychology*; D005500:Follow-Up Studies; D006801:Humans; D007989:Libido; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010410:Penile Erection / Q000523:psychology; D010555:Personality Inventory / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000523:psychology*; D011468:Prostatectomy / Q000523:psychology*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000523:psychology* / Q000601:surgery*; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D012017:Referral and Consultation; D012752:Shame