Prevalence and Predicting Factors for Commonly Neglected Sexual Side Effects to Radical Prostatectomies: Results from a Cross‐Sectional Questionnaire‐Based Study. (1st September 2014)

• Record Type: Journal Article
• Authors: Frey, Anders; Sønksen, Jens; Jakobsen, Henrik; Fode, Mikkel
• Is Part Of: Journal of sexual medicine. Volume 11:Number 9(2014:Sep.)
• Page Start: 2318
• Page End: 2326
• Publication Date: 2014-09-01
• Subjects: Radical Prostatectomy -- Side Effects -- Sexual Dysfunction -- Orgasmic Dysfunction -- Climacturia -- Urinary Incontinence -- Penile Shortening -- Orgasm‐Associated Pain; Sexual disorders -- Periodicals; Sex -- Periodicals; Sexual health -- Periodicals; 616.69005
• DOI: 10.1111/jsm.12624
• Languages: English
• ISSNs: 1743-6095

Abstract

Abstract: Introduction: 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. Aim: 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. Main Outcome Measures: 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.