Can sexual bother after radical prostatectomy be predicted preoperatively? Findings from a prospective national study of the relation between sexual function, activity and bother

摘要

OBJECTIVE: ? To explore the prevalence and prediction of overall sexual bother (SB) 1 year after radical prostatectomy (RP) in relation to preoperative sexual activity and postoperative sexual function. PATIENTS AND METHODS: ? This prospective national study included 453 men who completed the sexual domain of the Expanded Prostate Cancer Index Composite before and 1 year after RP. ? Preoperatively the patients were classifi ed as sexually active or inactive based on frequency of intercourse during the previous 4 weeks. ? The prevalence of 1-year SB and the proportion of bothered patients with impaired sexual function were calculated. ? Preoperative factors signifi cantly associated with postoperative SB on univariate analysis (P < 0.05) were included in multivariate regression analysis, post-prostatectomy SB being the dependent variable. RESULTS: ? The prevalence of SB increased from 18% preoperatively to 66% at 1 year after RP with a larger proportion of change in the active than the inactive group (59% vs 25%). ? The proportion of men reporting postoperative SB related to their impaired sexual function 1 year after RP was signifi cantly higher in the preoperatively sexually active group (83%) compared with the inactive group (63%). ? In multivariate analysis preoperative SB, sexual activity and nervousness (neuroticism) signifi cantly predicted postoperative SB with odds ratios of 3.71, 2.11 and 1.57, respectively. CONCLUSION: ? Sexual activity and SB the last month before prostatectomy and neuroticism identify men at risk of developing SB 1 year postoperatively. Assessment of preoperative sexual activity and SB should be a part of preoperative counselling.