title: Prevalence and predicting factors for commonly neglected sexual side effects to radical prostatectomies: results from a cross-sectional questionnaire-based study.
abstract: BACKGROUND
  Altered perception of orgasm, orgasm-associated pain, penile sensory changes, urinary incontinence (UI) during sexual activity, penile shortening (PS), and penile deformity following radical prostatectomy (RP) have received increasing attention from researchers.
  
  
  OBJECTIVE
  The aim of this study is to describe the prevalence and predictors of the above-mentioned side effects.
  
  
  METHODS
  This was a cross-sectional questionnaire-based study among men who had undergone RP between 3 and 36 months prior to study inclusion. Predicting factors were identified through logistic regression analyses.
  
  
  METHODS
  The primary outcome measures were prevalence rates of the above-mentioned side effects.
  
  
  RESULTS
  Overall, 316 questionnaires were available for analyses. Of the sexually active patients (n = 256), 12 (5%) reported anorgasmia, whereas 153 (60%) reported decreased orgasm intensity. Delayed orgasms were reported by 146 (57%). Twenty-three patients (10%) had experienced pain during orgasm. UI during sexual activity were reported by 99 patients (38%). Out of the whole population, 77 patients (25%) reported sensory changes in the penis. A total of 143 patients (47%) reported a subjective loss of penile length of >1 cm. An altered curvature of the penis was reported by 30 patients (10%). Patients had increasing risk of UI during sexual activity (odds ratio [OR] 1.17; 95% confidence interval [CI] 1.10-1.25) and orgasmic dysfunction (OR 1.09; 95% CI 1.01-1.16) with increasing International Consultation on Incontinence Questionnaire scores. Erectile dysfunction (OR 1.81; 95% CI 1.07-3.10) and a high body mass index (OR 1.10; 95% CI 1.02-1.19) increased the risk of PS after RP. Nerve-sparing (OR 0.32; 95% CI 0.16-0.95) reduced the risk of PS.
  
  
  CONCLUSIONS
  Orgasm-associated problems, UI during sexual activity, penile sensory changes, PS, and penile deformity are common side effects to RP. Daytime UI, erectile dysfunction, and nerve-sparing status can help identify patients at risk.
authors.affiliation: Department of Urology, Herlev Hospital, Copenhagen, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Frey
authors.forename: Jens
authors.initials: J
authors.lastname: Sønksen
authors.forename: Henrik
authors.initials: H
authors.lastname: Jakobsen
authors.forename: Mikkel
authors.initials: M
authors.lastname: Fode
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D007172:Erectile Dysfunction / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009948:Orgasm; D011468:Prostatectomy / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000209:etiology*
keywords: Climacturia; Orgasm-Associated Pain; Orgasmic Dysfunction; Penile Shortening; Radical Prostatectomy; Sexual Dysfunction; Side Effects; Urinary Incontinence