title: Management of sexual side effects in the surgical oncology practice: A nationwide survey of Dutch surgical oncologists.
abstract: BACKGROUND
  Sexual function is an important factor in quality of life, but at risk after several surgical cancer treatments. Our aim was to identify the practice, responsibility, attitudes, knowledge and barriers of surgical oncologists towards providing informed consent on sexual side effects and sexual counselling.
  
  
  METHODS
  A 31-item questionnaire was sent to all 437 members of the Dutch Society for Surgical Oncology (NVCO).
  
  
  RESULTS
  The majority of 165 responding surgical oncologists (85.5%) stated that discussing sexual function is their responsibility, 13.0% thought it to be somebody else's responsibility. During informed consent of a planned surgical procedure, sexual side effects are mentioned by 36.6% of surgeons in more than half of the cases. Counselling sexual function was performed by 9.2% of the surgeons in more than half of the cases. Older surgeons (≥46 y) and male surgeons discuss sexual concerns more often (p = 0.006 v p = 0.045). Barriers most mentioned included advanced age of the patient (50.6%), not relevant for all types of cancers (43.8%), lack of time (39.9%) and no angle or motive for asking (35.2%). Additional training on counselling patients for sexual concerns was required according to 46.3%.
  
  
  CONCLUSIONS
  Surgical oncologists do not routinely discuss sexual concerns. Informed consent includes limited information about possible complications on sexual function. Surgeons consider themselves responsible for raising the issue of sexual dysfunction, but consider advanced age of patients, lack of time and no angle or motive for asking as major barriers. Results emphasize the need for raising awareness and providing practical training.
authors.affiliation: Department of Urology, Leiden University Medical Centre, PO Box 9600, 2300 WB Leiden, The Netherlands. Electronic address: e.m.krouwel@lumc.nl.
authors.forename: E M
authors.initials: EM
authors.lastname: Krouwel
authors.affiliation: Department of Urology, Leiden University Medical Centre, PO Box 9600, 2300 WB Leiden, The Netherlands. Electronic address: jelkehagen@gmail.com.
authors.forename: J H
authors.initials: JH
authors.lastname: Hagen
authors.affiliation: Department of Urology, Leiden University Medical Centre, PO Box 9600, 2300 WB Leiden, The Netherlands. Electronic address: melianthenicolai@gmail.com.
authors.forename: M P J
authors.initials: MP
authors.lastname: Nicolai
authors.affiliation: Department of Surgical Oncology, Leiden University Medical Centre, PO Box 9600, 2300 WB Leiden, The Netherlands. Electronic address: a.l.vahrmeijer@lumc.nl.
authors.forename: A L
authors.initials: AL
authors.lastname: Vahrmeijer
authors.affiliation: Department of Medical Statistics, Leiden University Medical Centre, PO Box 9600, 2300 WB Leiden, The Netherlands. Electronic address: h.putter@lumc.nl.
authors.forename: H
authors.initials: H
authors.lastname: Putter
authors.affiliation: Department of Urology, Leiden University Medical Centre, PO Box 9600, 2300 WB Leiden, The Netherlands. Electronic address: r.c.m.pelger@lumc.nl.
authors.forename: R C M
authors.initials: RC
authors.lastname: Pelger
authors.affiliation: Department of Urology, Leiden University Medical Centre, PO Box 9600, 2300 WB Leiden, The Netherlands. Electronic address: h.w.elzevier@lumc.nl.
authors.forename: H W
authors.initials: HW
authors.lastname: Elzevier
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003376:Counseling; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D009369:Neoplasms / Q000601:surgery*; D009426:Netherlands; D011183:Postoperative Complications / Q000175:diagnosis* / Q000628:therapy; D010818:Practice Patterns, Physicians'; D011788:Quality of Life; D060728:Reproductive Health; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis* / Q000628:therapy; D020018:Sexual Dysfunctions, Psychological / Q000175:diagnosis* / Q000628:therapy; D013043:Specialties, Surgical; D011795:Surveys and Questionnaires
keywords: Cancer; Informed consent; Quality of life; Sexual dysfunction; Sexuality; Surgeons