INTRODUCTION: The literature on sexual bother in men with prostate cancer is conflicting. While some data indicate high bother from erectile dysfunction (ED) following prostate cancer treatments, other results suggest the life-saving nature of the treatment may mitigate ED concern. AIM: (i) To determine if sexual bother increases post radical prostatectomy (RP); (ii) To determine if men psychologically adjust to diminished erections; (iii) To identify baseline predictors of post-RP sexual bother. METHODS: We identified 183 men treated with RP who completed inventories including Erectile Function Domain (EFD) and Sexual Bother (SB) preoperatively and at 12 and 24 months postoperatively. Statistical analyses included repeated-measures analysis of variance and linear multiple regression. MAIN OUTCOME MEASURES: The EFD of the International Index of Erectile Function and the SB subscale from the Prostate-Health Related Quality-of-Life Questionnaire. RESULTS: The mean age of the sample was 58 +/- 7 years. The mean EFD scores decreased from baseline to the 24-month time point (24.8 vs. 16.7, P < 0.01). The mean SB scores increased from baseline to the 12 month time point (4.3 vs. 6.7, P < 0.01), and remained stable from the 12 month to 24 month time points (6.7 vs. 6.3, P = not significant [ns]). This was true for men with ED (EFD < 24) and without ED. Only 7% of men with ED moved from being "bothered" at 12 months to "no bother" at 24 months. There were no significant baseline predictors of sexual bother; baseline variables tested were: age, race, marital status, prostate-specific antigen (PSA) value, EFD, sexual desire, and intercourse satisfaction. The change in EFD scores was the only significant predictor of SB scores. CONCLUSIONS: Sexual bother increases post-RP, even in men with "good" erections postoperatively, and includes shame, embarrassment, and a reduction in general life happiness. Because men do not seem to "adjust" to ED, referral or evaluation should occur early in this population.
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机译：简介：有关前列腺癌男性性困扰的文献相互矛盾。尽管一些数据表明前列腺癌治疗后勃起功能障碍（ED）引起严重困扰，但其他结果表明该疗法具有挽救生命的性质，可以减轻对ED的担忧。目的：（i）确定前列腺癌根治术后是否会增加性困扰; ii确定男子是否在心理上适应勃起减少; （iii）确定RP后性困扰的基线预测因素。方法：我们确定了183名接受RP治疗的男性患者，这些男性患者在术前以及术后12和24个月完成了包括勃起功能域（EFD）和性困扰（SB）的清单。统计分析包括方差的重复测量分析和线性多元回归。主要观察指标：前列腺健康相关生活质量调查表中国际勃起功能指数和SB分量表的EFD。结果：样本的平均年龄为58 +/- 7岁。 EFD的平均分数从基线下降到24个月的时间点（24.8对16.7，P <0.01）。 SB平均得分从基线到12个月时间点增加（4.3 vs. 6.7，P <0.01），从12个月到24个月时间点保持稳定（6.7 vs. 6.3，P =不显着[ns]） 。对于患有ED（EFD <24）而没有ED的男性，情况确实如此。仅有7％的ED男性从12个月的“分娩”变为24个月的“无烦恼”。没有显着的性骚扰的基线预测因子。测试的基线变量为：年龄，种族，婚姻状况，前列腺特异性抗原（PSA）值，EFD，性欲和性交满意度。 EFD分数的变化是SB分数的唯一重要预测指标。结论：即使在术后勃起良好的男性中，性困扰也增加了RP后的状况，包括羞耻，尴尬和一般生活幸福感的降低。由于男性似乎并未“适应”急诊科，因此应在该人群中尽早进行转诊或评估。
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