title: Sexual dysfunction after cystectomy and urinary diversion.
abstract: Erectile dysfunction (ED) in men and sexual dysfunction in men and women are common after cystectomy and urinary diversion. Research has focused on both qualifying the prevalence of ED following cystectomy and identifying surgical approaches to limit sexual dysfunction after surgery, but most studies have been limited by small patient populations, an absence of control groups, and a lack of adjustment for confounding factors. Similarly, quality of life (QoL) research studies have also emerged in the context of bladder cancer and cystectomy, and increase our understanding of sexual outcomes associated with cystectomy. A number of instruments for collection of patient-reported outcomes among patients with bladder cancer treated with cystectomy are available for the assessment of condition-specific and procedure-specific QoL. However, other factors that negatively affect sexual function after removal of the bladder, such as psychological issues, age, and health-related competing risks for ED, body image, partner response, and change in life course and sexual priorities, have received less attention. Nevertheless, ED and sexual dysfunction are important complications of cystectomy and urinary diversion. Although changes in the approach to surgery, such as nerve-sparing cystectomy, might improve outcomes, evaluation and management of the source factors of ED and sexual dysfunction are necessary to optimize recovery of function.
authors: Department of Urology, University of Florida College of Medicine, 1600 SW Archer Road, Gainesville, FL 32603, USA.
authors: Rishi A
authors: RA
authors: Modh
authors: Male Sexual and Reproductive Medicine Program, Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
authors: John P
authors: JP
authors: Mulhall
authors: Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA.
authors: Scott M
authors: SM
authors: Gilbert
mesh_terms: D015653:Cystectomy / Q000379:methods; D007172:Erectile Dysfunction / Q000209:etiology / Q000517:prevention & control / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control / Q000628:therapy; D011788:Quality of Life; D012735:Sexual Dysfunction, Physiological / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy; D014547:Urinary Diversion