[Hopespringpcsg] FW: FYI From medpagetoday.com Topic: Men Unclear on Sexual Function After Prostatectomy

[Glen Tolhurst]

Hi all:

Interesting article below.

Thx.

Glen

 


Subject: FYI From medpagetoday.com Topic: Men Unclear on Sexual Function After Prostatectomy

 


Men Unclear on Sexual Function After Prostatectomy


Many unaware of sexual adverse effects, recovery issues


Men who underwent radical prostatectomy had unrealistic expectations about how well they would function sexually postoperatively, especially men who had robotic radical prostatectomy, according to survey results.

 

In a survey of 336 patients who had undergone radical prostatectomy, only 38% of respondents accurately recollected whether they had had a nerve sparing procedure 3 months after undergoing either an open radical prostatectomy or the robotic equivalent, reported Serkan Deveci, MD <https://www.researchgate.net/profile/Serkan_Deveci/publications> , of Memorial Sloan Kettering Cancer Center in New York City, and colleagues.

 

Only 70% of men who had undergone an open radical prostatectomy and 60% of their robotic counterparts were aware that they were rendered anejaculatory by their surgery (P=0.065), they wrote in BJU International <http://www.bjuinternational.com/> .

 

Few if any patients in either group were aware that the nature of an orgasm could change following the surgery (P=0.09), that they could have pain on orgasm (P=0.2), or that they could leak urine at the moment of climax (P=0.15).

 

None of the patients who had undergone robotic radical prostatectomy and only 10% of those who had undergone an open procedure recalled being told that there was a potential for loss of penile length (P<0.01).

And no patient in either group was aware of the association between radical prostatectomy and Peyronie's disease <http://www.urologyhealth.org/urologic-conditions/peyronies-disease>  that can be caused by scar tissue formation following the surgery.

 

"Patients who have undergone radical prostatectomy have unrealistic expectations with regard to postoperative sexual function," the authors wrote.

 "We encourage all clinicians to utilize written instructions to transmit sexual health information to patients, lest they receive the orally transmitted information in a state of anxiety where failure to process the information may be highly likely."

 

The study sheds light on the importance of managing expectations for patients undergoing surgical therapy for prostate cancer, said Charles Ryan, MD, <http://profiles.ucsf.edu/charles.ryan>  of the University of California San Francisco.

"It suggests that clinicians involved in recommending such therapies should be aware of this 'expectation gap' during the time that they counsel patients about upcoming treatments,"

 Ryan, a prostate cancer spokesperson for the American Society of Clinical Oncology, told MedPage Today in an email. "Risks to sexual function may be a topic that patients and clinicians are both reluctant to bring up and so these data may be used as an effective conversation starter."

 

Although the study involved data from a small group of surgeons at a single center, "it can be instructive to all of us helping to guide patients through the maze of treatment options and their potential hazards," added Ryan, who was not involved in the research.

 

The survey participants had a mean age 64 and sought consultation at a sexual medicine clinic within 3 months of their radical prostatectomy.

The study population comprised 216 men, who had undergone open radical prostatectomy, and 120 men who had robot-assisted radical prostatectomy.

All patients were asked to complete a questionnaire regarding their expectations about recovery of sexual function following the surgery.

Questions included those on erectile function and the time men expected to make a full recovery of their former erectile status along with other potential changes in ejaculatory status,

 penile morphology, and their expected need for postoperative intracavernosal injections to help with erections.

 

"Patient knowledge regarding post-radical prostatectomy sexual function was poor with significant differences between the open and the robotic radical prostatectomy groups," Deveci and colleagues observed.

 

For example, patients who had undergone robotic radical prostatectomy expected that they would recover erectile function in 6 months compared with 12 months for men who had undergone an open procedure (P=0.02).

 

More robotic radical prostatectomy patients (75%) expected that their erectile function would return to normal baseline levels than patients who underwent open radical prostatectomy (50%, P=0.01).

Men who had undergone a robotic procedure also felt that they would be much less likely to need intracavernosal injections to achieve an erection (4%) compared with their open prostatectomy counterparts (20%, P=0.01).

 

Limitations to the study include lack of an instrument to define patient expectations, and investigators' inability to differentiate between what patients were told and what patients remembered.

Another limitation was investigators' inability to ascertain if some patients did their own research before or after they had seen their surgeon and prior to undergoing the procedure.

 

"These data are illuminating and should give us reason to think about our approach to the education of the patient prior to radical prostatectomy,"

 Deveci's group noted. "Irrespective of whether we as clinicians routinely have a sexual dysfunction discussion or not, patients are not remembering or appreciating the information

 the way it is intended and undertake the operation with poor expectations regarding multiple domains of sexual health"

"Surgeons should be encouraged to be thorough in counseling patients prior to radical prostatectomy and to document that [at least] such a discussion was held," they wrote.

 

Deveci and co-authors disclosed no relevant relationships with industry.

 

 

 

url:http://www.medpagetoday.com/HematologyOncology/ProstateCancer/55547?xid=NL_breakingnews_2016-01-07 <url:http://www.medpagetoday.com/HematologyOncology/ProstateCancer/55547?xid=NL_breakingnews_2016-01-07&eun=g247904d0r> &eun=g247904d0r

 

 

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