Female sexual dysfunction after radical cystectomy: a new outcome measure

Zippe, Craig D.; Raina, Rupesh; Shah, Asha D.; Massanyi, Eric Z.; Agarwal, Ashok; Ulchaker, James; Jones, Stephen E.; Klein, Eric A.

doi:10.1016/j.urology.2003.12.034

Cited by 115 publications

(75 citation statements)

References 24 publications

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“…Most important reasons for their dysfunction were loss of sexual desire, vaginal dryness and dyspareunia. However, later studies by Bjerre et al 42 and Zippe et al 43 failed to reveal any significant difference between the type of urinary diversion and sexual dysfunction. Bjerre et al evaluated sexual profile after different types of urinary diversion in women with RC.…”

Section: Sexual Dysfunction In Femalesmentioning

confidence: 94%

Sexual dysfunction after pelvic surgery

et al. 2005

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Pelvic surgeries are among the most common causes of organic sexual dysfunction in men and women. The impact of nerve-sparing surgery on potency has been well documented in radical prostatectomy. However, its impact on potency needs to be evaluated in other pelvic surgeries. Sexual dysfunction is highly prevalent even after multiple technical advances in the field of oncological surgeries. The prevalence varies from 8 to 82%, depending on the type of pelvic surgery. In females, sexual dysfunction has not been evaluated adequately using validated questionnaires. However, in subspecialized circles, treatment for female sexual dysfunction is becoming routine. Currently, physicians have several options for the treatment of erectile dysfunction (ED) in men. Since the introduction of oral PDE-5 inhibitors, oral therapy has become the first-line treatment option for ED, irrespective of etiology. Currently available treatment options for the female sexual dysfunction include estrogens, androgens, phosphodiesterase inhibitors, and dopamine receptor antagonists. Initial reports regarding the role of early rehabilitation are encouraging and may become the part of routine practice in the management of ED after pelvic surgery. In this article, we summarize the sexual dysfunction following pelvic surgeries and their management. International Journal of Impotence Research (2006) IntroductionErectile dysfunction (ED) is defined as the inability to achieve and maintain an erection sufficient for satisfactory sexual intercourse. 1 Several factors have been implicated in the etiology of ED. Vascular and neurogenic causes are the most common among them. Diabetes, smoking and hypertension are the most important risk factors for vasculogenic sexual dysfunction. Neurological dysfunction is mainly associated with certain neurological syndromes like autonomic neuropathy. Sexual dysfunction after pelvic surgery has been an important and underreported cause of ED. The pathophysiology of sexual dysfunction after pelvic surgery is unique because it can be either vascular or neurogenic factors alone, or a combination of both. The pelvic surgeries in males that are associated with considerable ED include radical prostatectomy (RP), radical cystoprostatectomy (cystectomy) and low anterior or abdominoperineal resections (APRs) for rectal cancer. The pelvic surgeries in females associated with sexual dysfunction include radical cystectomy (RC) for bladder cancer, radical hysterectomy for cancers of the cervix and endometrium and, potentially, simple hysterectomy for benign tumors.In this article, we summarize male and female sexual dysfunction following pelvic surgeries for prostate, bladder and rectal cancer. We also discuss our experience in the treatment of sexual dysfunction following RP and RC. than 10%, urologists still report that the majority of patients experience ED following RRP. [3][4][5] Until recently, ED following RP was not an overwhelming concern, as most prostate cancers were detected in older men. 6 However, since the adven...

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Section: Sexual Dysfunction In Femalesmentioning

confidence: 94%

Sexual dysfunction after pelvic surgery

et al. 2005

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“…Zippe et al mentioned diminished ability to achieve orgasm in 12/27 patients (45 %), a decreased lubrication in 11/27 patients (41 %), a decreased sexual desire in 10/27 patients (37 %), and dyspareunia in 6/27 patients (22 %). They reported that only 13/27 patients (48 %) were able to achieve a successful vaginal intercourse [12].…”

Section: Discussionmentioning

confidence: 99%

Genital Sparing Cystectomy for Female Bladder Cancer and its Functional Outcome; a Seven Years' Experience with 24 Cases

Roshdy

Senbel

Khater

et al. 2015

Indian J Surg Oncol

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The surgical treatment of bladder cancer is the curative treatment especially in early cases. In this study, our aim was to assess the outcome of preservation of internal genital organs in selected females both oncologically and functionally, and to assess the feasibility of technique and its complication. 24 females with clinically and radiologically diagnosed T2 bladder cancer underwent gynecologic-tract sparing cystectomy (GTSC). Age ranged from 45 to 60 years. Patients with diffuse carcinoma-in-situ, those with tumors involving the bladder neck, those with poor general condition and those with preoperative incontinence were excluded. 1 patient, who developed local recurrence after 6 months. One patient lost follow up after 15 months. No recurrence developed in the retained genital organs. The remaining 20 patients remained free of disease. Among women who were eligible for functional evaluation, Daytime and nighttime continence were satisfactory in 21/22 (95.4 %) and in 20/22 (90.9 %) respectively. Chronic urinary retention, pouch-vaginal fistula was not noted. Most of patients showed superior Sexual Function index. Cystectomy with preservation of the internal genital organs is feasible in female with early, solitary or T2 bladder cancer with satisfactory functional and oncologic outcomes with proper case selection.

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“…Most of them conceived cystectomies for oncological indications and were related to male sexual function. Only a few reports were related to female sexual function [4][5][6][7]. Zippe at al.…”

Section: Discussionmentioning

confidence: 99%

Sexual function after partial cystectomy and urothelial stripping in a 32-year-old woman with radiation cystitis

2005

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We report a case of a 32-year-old woman who underwent a partial cystectomy to preserve sexual function. After radiotherapy for stage IB1 cervical cancer, cystectomy was indicated because of severe radiation cystitis. During this procedure we resected the upper part of the bladder followed by stripping off urothelium of the remaining bladder to spare the neurovascular bundle. Follow-up after 3 months indicated intact sexual function including orgasm. In our opinion the cystectomy procedure described in this case report is a good, novel option in women who are candidates for cystectomy because of a crippled bladder, after radiotherapy, and want to retain sexual function.

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Female sexual dysfunction after radical cystectomy: a new outcome measure

Cited by 115 publications

References 24 publications

Sexual dysfunction after pelvic surgery

Sexual dysfunction after pelvic surgery

Genital Sparing Cystectomy for Female Bladder Cancer and its Functional Outcome; a Seven Years' Experience with 24 Cases

Sexual function after partial cystectomy and urothelial stripping in a 32-year-old woman with radiation cystitis

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