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Query: UMLS:C0376358 (prostate cancer)
 59,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sexual histories were obtained from 51 patients (average age 67.7 years) with prostatic cancer and their spouses before and after pelvic lymphadenectomy and retropubic 125iodine implantation. Sexual potency was retained in 40 of the 41 patients who were sexually active preoperatively. Ten patients were sexually inactive preoperatively: 4 with diminished potency and 6 with complete erectile impotence. Sexual dysfunction was most often psychogenic in origin. At 6 months 5 of these patients had resumed satisfactory sexual intercourse as a result of reassurance, encouragement and education of remaining sexual potential. No patient suffered complete erectile impotence as a result of the procedure.
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PMID:Preservation of sexual potency in prostatic cancer patients after pelvic lymphadenectomy and retropubic 125I implantation. 43 58

Sexual histories were obtained in 51 men with prostatic cancer and their spouses, before and after pelvic lymphadenectomy and retropubic 125I implantation. The average age of the patients was 64.7 years. Sexual activity was retained in 40 of the 41 patients who were sexually active before operation. Ten patients had been sexually inactive before operation--4 with diminished potency and 6 with complete erectile impotence. Sexual dysfunction was most often pyschogenic. At six months after the operation, 5 of these patients had resumed satisfactory sexual intercourse as a result of reassurance, encouragement and education of the remaining sexual potential. No patient was rendered completely impotent as a result of the procedure. Preservation of sexual potency represents a significant advantage of 125I implantation over other therapeutic modalities in the treatment of localized prostatic carcinoma.
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PMID:Preservation of sexual potency in prostatic cancer patients after 125I implantation. 75 69

Treatment modalities for prostate cancer include surgery, radiation therapy, and hormonal manipulation. Sexual dysfunction is a potential sequela of these treatments. Ideally, nursing interventions are begun before treatment is initiated. Pertinent questions enable nurses to elicit specific information needed to develop the patient's care plan. Sexual assessment strategies and interventions, such as the PLISSIT model, that can be implemented when caring for these patients are presented.
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PMID:Sexual dysfunction following treatment for prostate cancer: nursing assessment and interventions. 827 82

Common urologic complaints in the midlife man include bladder outlet obstruction, bladder hyperactivity, and large urinary output. Obstruction can result from benign prostate hypertrophy or some other problem distal to the bladder neck, such as urethral stricture. Hyperactivity can be induced by stress and caffeine or can suggest neurologic disease or bladder neoplasia. Large urinary output suggests excessive fluid intake, diabetes insipidus or mellitus, or mobilization of fluid from the use of diuretics or reclining at night. Sexual dysfunction may be caused by stress, but it is more often linked to peripheral vascular disease. Screening for prostate cancer is controversial; the benefit of PSA testing is most clear in patients at elevated risk (eg, due to race or family history).
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PMID:Urologic 'nuisances': how to work up and relieve men's symptoms. 905 86

Improvements in the management of prostate cancer have increased the need to consider patients' quality of life, in particular in relation to sexual function. The causes of sexual dysfunction are varied and derive from both the condition and its management. Health professionals must choose their treatment strategies with great care. Patient expectations must be understood, and patients should be offered counselling, as an understanding of what can reasonably be expected contributes to patients' perception of their quality of life. There are few studies on sexual dysfunction in patients with prostate cancer. A first step would be to develop reliable questionnaires for the assessment of the problem. This article describes and discusses the findings of one such recently developed questionnaire. When baseline measures of sexual function have been established and the extent of sexual dysfunction in patients with prostate cancer is reliably quantified, large multicentre trials can be performed to evaluate the impact of different therapies on sexual function and quality of life. Sexual dysfunction is an area which will be of increasing importance to urologists who manage prostate cancer and one that should not be underestimated.
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PMID:Sexual dysfunction associated with the management of prostate cancer. 974 91

In a questionnaire study, men with prostate cancer (n = 155) or benign prostatic hyperplasia (n = 131) identified more sexual problems than did men from the general population (n = 129). Sexual dysfunction was acknowledged regarding sexual pleasure and attraction, erectile function and sexual satisfaction and sexual performance. Lowered rates of sexual desire, pleasure and attraction were found when comparing their situation in recollection of pre-treatment situation to the current situation. Lower intercourse frequency and sexual satisfaction were also found. Medication, masturbation and artificial aids to achieve erection were not used as substitutes for shortcomings of erectile function either by men with prostate cancer and benign prostatic hyperplasia nor by their partners. There seemed to be a lack of information about the illness and treatment consequences for sexual life, including what physical dysfunction to expect after surgery and also what possible help to expect to compensate for the shortcomings.
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PMID:Sexual problems in men with prostate cancer in comparison with men with benign prostatic hyperplasia and men from the general population. 1182 5

Sexual dysfunction is common after surgery for prostate cancer. The aetiology of changes in sexual potency after radical prostatectomy is probably multifactorial, including neurogenic, vascular and psychosexual factors. A prospective study was designed to investigate haemodynamic and psychosexual changes before and after radical retropubic prostatectomy (RRP) for organ-confined prostate cancer. Penile haemodynamic evaluation and an assessment of sexual excitement were performed preoperatively and 3 months after RRP by colour Doppler ultrasonography (CDU) with visual erotic stimulation combined with a single intracavernous injection of a mixture of papaverine/phentolamine. Questionnaires on sexual function [International Index of Erectile Function (IIEF)], general health and quality of life were sent to the patients preoperative, 3 months and 5 years after operation. Forty-eight men participated in the study. Mean age was 62.6 years (range 55-69). CDU did not show any significant reduction in mean peak systolic flow velocity and mean resistance index. From the men who preoperatively had normal arterial inflow 18% developed arteriogenic insufficiency. Some form of veno-occlusive insufficiency and low resistance indices were already present in the majority of normal potent men preoperatively. Surgical technique did not influence penile arterial blood flow after the operation. Three months and 5 years postoperatively, there was a highly significant reduction in erectile function, intercourse satisfaction, overall satisfaction, orgasmic function and sexual desire. However, with respect to the outcome at 3 months there was a significant improvement of orgasmic function 5 years after operation, especially after a bilateral nerve sparing procedure. Erections sufficient for vaginal penetration (questions 3 and 4 of the IIEF, score >or=8) improved from 2% to 11% 3 months and 5 years after RRP respectively. Total IIEF score was significantly better after a bilateral nerve-sparing procedure compared with non-nerve sparing. No structural vascular changes were observed 3 months after operation. Vascular factors appear to be less important in the aetiology of ED after RRP. There seems to be a trend of a better improvement of sexual function over time, especially orgasmic function, in patients with bilateral nerve-sparing surgery.
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PMID:Penile vascular evaluation and sexual function before and after radical retropubic prostatectomy: 5-year follow-up. 1765

Decision making for treatment of localized prostate cancer is often guided by therapeutic side-effect profiles. We sought to assess health-related quality-of-life outcomes for patients 48 months after treatment for localized prostate cancer. Men treated for localized prostate cancer (N = 475) were evaluated before treatment and at 11 intervals during the 48 months after intervention. Changes in mean health-related quality-of-life scores and the probability of regaining baseline levels of health-related quality of life were compared between treatment groups. All statistical tests were two-sided. Urinary incontinence was more common after prostatectomy (n = 307) than after brachytherapy (n = 90) or external beam radiation therapy (n = 78) (both P < .001), whereas voiding and storage urinary symptoms were more prevalent after brachytherapy than after prostatectomy (both P < .001). Sexual dysfunction profoundly affected all three treatment groups, with a lower likelihood of regaining baseline function after prostatectomy than after external beam radiation therapy or brachytherapy (P < .001). Bowel dysfunction was more common after either form of radiation therapy than after prostatectomy. These results may guide decision making for treatment selection and clinical management of patients with health-related quality-of-life impairments after treatment for localized prostate cancer.
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PMID:Survivorship beyond convalescence: 48-month quality-of-life outcomes after treatment for localized prostate cancer. 1950 58

BACKGROUND: The choice between surgical versus non-surgical treatment options is a fundamental decision for men with local stage prostate cancer because of differences in risks of genitourinary side effects among available treatments. OBJECTIVES: We assessed whether preexisting genitourinary symptoms at the time of diagnosis influenced men's preferences for surgery versus other management options. METHODS: We recruited 593 patients with newly diagnosed local stage prostate cancer prior to initiating treatment from an integrated health care system, an academic urology center, and community urology clinics. Using logistic regression we compared whether men had a preference for non-surgical options or only preferred surgery. RESULTS: Nearly 60% indicated they were considering non-surgical options. Age and clinical characteristics but not preexisting genitourinary symptoms influenced the decision between preferences for surgical or non-surgical options. A total of 62% of men reported side effects as a main factor in their treatment decision. Men with more aggressive tumor types were less likely to consider side effects, however, men who reported poor ability to have an erection were more likely to consider side effects (p<0.001). CONCLUSION: Sexual dysfunction at time of diagnosis, but not other genitourinary symptoms, is associated with men considering treatment-related side effects when considering surgery versus other options. Men who are not experiencing sexual dysfunction at diagnosis may discount the risks of side effects in the decision making process.
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PMID:Association of Preexisting Symptoms with Treatment Decisions among Newly Diagnosed Prostate Cancer Patients. 2011 93

Sexual dysfunction is the most significant long lasting effect of prostate cancer (PrCa) treatment. Despite the many medical treatments for erectile dysfunction, many couples report that they are dissatisfied with their sexual relationship and eventually cease sexual relations altogether. We sought to understand what distinguishes successful couples from those who are not successful in adjusting to changes in sexual function subsequent to PrCa treatment. Ten couples who maintained satisfying sexual intimacy after PrCa treatment and seven couples that did not were interviewed conjointly and individually. Interviews were transcribed and analyzed using grounded theory methodology. The theory that resulted suggests that individuals are motivated to engage in sex primarily because of physical pleasure and relational intimacy. The couples who valued sex primarily for relational intimacy were more likely to successfully adjust to changes in sexual function than those who primarily valued sex for physical pleasure. The attributes of acceptance, flexibility, and persistence helped sustain couples through the process of adjustment. Based on these findings, a new theory, the Physical Pleasure-Relational Intimacy Model of Sexual Motivation (PRISM) is presented. The results elucidate the main motives for engaging in sexual activity-physical pleasure and/or relational intimacy-as a determining factor in the successful maintenance of satisfying sexual intimacy after PrCa treatment. The PRISM model predicts that couples who place a greater value on sex for relational intimacy will better adjust to the sexual challenges after PrCa treatment than couples who place a lower value on sex for relational intimacy. Implications of the model for counselling are discussed. This model remains to be tested in future research.
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PMID:Sexual values as the key to maintaining satisfying sex after prostate cancer treatment: the physical pleasure-relational intimacy model of sexual motivation. 2404 2


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