title: Erectile dysfunction and sexual health after radical prostatectomy: impact of sexual motivation.
abstract: The life expectancy of patients with localized prostate cancer at treatment initiation has increased, and post-treatment quality of life has become a key issue. The aim of this study is to assess the impact of Radical prostatectomy (RP) on patients' sexual health and satisfaction according to sexual motivation using a self-administered questionnaire completed by two groups of RP patients, with high or lower levels of sexual motivation. A total of 63 consecutive patients were included (mean age, 63.9 years), of whom 74.6% were being treated for erectile dysfunction (ED). After RP, patients reported lower sexual desire (52.4%), reduced intercourse frequency (79.4%), anorgasmia (39.7%), less satisfying orgasm (38.1%), climacturia (25.4%), greater distress (68.3%) and/or lower partner satisfaction (56.5%). Among the most sexually motivated patients, 76.0% reported loss of masculine identity, 52% loss of self-esteem and 36.0% anxiety about performance. These rates were lower among less motivated patients (52.6, 28.9, and 18.4%, respectively). Mean overall satisfaction score was 4.8 ± 2.9. The score was significantly lowered in motivated than less motivated patients (3.4 vs 5.8) (P = 0.001). In conclusion, RP adversely affected erectile and orgasmic functions but also sexual desire, self-esteem and masculinity. The more motivated patients experienced greater distress and were less satisfied.
authors.affiliation: Department of Urology and Andrology, Robert Debré Academic Hospital, Reims, France. messaoudirabah@hotmail.com
authors.forename: R
authors.initials: R
authors.lastname: Messaoudi
authors.forename: J
authors.initials: J
authors.lastname: Menard
authors.forename: T
authors.initials: T
authors.lastname: Ripert
authors.forename: H
authors.initials: H
authors.lastname: Parquet
authors.forename: F
authors.initials: F
authors.lastname: Staerman
mesh_terms: D000368:Aged; D003075:Coitus / Q000523:psychology; D007172:Erectile Dysfunction / Q000209:etiology / Q000523:psychology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009948:Orgasm; D011468:Prostatectomy / Q000009:adverse effects*