Partner’s Perspective on Long-term Sexual Dysfunction After Prostate Cancer Treatment

Movsas, Tammy Z.; Yechieli, Raphael; Movsas, Benjamin; Darwish-Yassine, May

doi:10.1097/coc.0000000000000067

Cited by 10 publications

(4 citation statements)

References 28 publications

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“…However, the physician can help these patients to appreciate that sexual dysfunction occurs in the context of an intimate partnership; therefore, the partner's needs, values, and difficulties are relevant to the sexual recovery process. 33,89,90 In this context, 'the identified patient' should be perceived as 'the couple' . In fact, sexual rehabilitation is most success ful if both partners participate in a recovery plan that responds to both partners' needs.…”

Section: Include Partnersmentioning

confidence: 98%

Psychosocial perspectives on sexual recovery after prostate cancer treatment

Walker¹,

Wassersug

Robinson³

2015

Nat Rev Urol

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Many therapies for erectile dysfunction (ED) after prostate cancer treatment improve erectile firmness, yet, most couples stop using aids within 1-2 years. Patients and partners who expect immediate and complete success with their first ED treatment can be demoralized when they experience treatment failure, which contributes to reticence to explore other ED aids. Comprehensive patient education should improve sustainability and satisfaction with ED treatments. Pre-emptive and realistic information should be provided to couples about the probability of recovering natural erections. Beginning intervention early and using a couple-based approach is ideal. Recommendations are provided about the timing of ED treatment, the order of aid introduction, and combination therapies. Renegotiation of sexual activity is an essential part of sexual adaptation. From the outset of therapy, couples should be encouraged to broaden their sexual repertoire, incorporate erection-independent sexual activities, and continue to be sexual despite ED and reduced libido.

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Section: Include Partnersmentioning

confidence: 98%

Psychosocial perspectives on sexual recovery after prostate cancer treatment

Walker¹,

Wassersug

Robinson³

2015

Nat Rev Urol

View full text Add to dashboard Cite

show abstract

“…Partnered men have better outcomes, make different treatment decisions, and get more social support than men who are not partnered (Bergman, Gore, Saigal, Kwan, & Litwin, 2009;Chamie et al, 2012;Kamen, Mustian, et al, 2015). Much of the literature on support for men with prostate cancer has focused on spousal support specific to heterosexual relationships (Harden et al, 2013b;McCaughan et al, 2013;Movsas, Yechieli, Movsas, & Darwish-Yassine, 2016). Although considerable evidence exists that GBMPCa have different social networks and support needs than heterosexual men with prostate cancer, no studies have considered the types of social support that GBMPCa receive or how social support is associated with QOL.…”

mentioning

confidence: 99%

Social Support and Health-Related Quality of Life Among Gay and Bisexual Men With Prostate Cancer

Capistrant¹,

Lesher²,

Kohli³

et al. 2018

ONF

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“…Involving partners in the management of ED recognizes that ED hinders the sexual life of both patients and their partners ( 18 , 33 ). The perception of how bothersome ED is may differ, though, between patients and partners ( 15 ).…”

Section: Perspective On Partner Engagementmentioning

confidence: 99%

“…A major concern with all ED treatments is that long-term adherence is poor ( 15 - 18 ). While some men may stop using an ED treatment because of natural recovery of erections, many men with persistent ED nevertheless withdraw from treatment.…”

Section: Introductionmentioning

confidence: 99%

Non-pharmacological and non-surgical strategies to promote sexual recovery for men with erectile dysfunction

Wassersug¹,

Wibowo²

2017

Transl. Androl. Urol.

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Erectile dysfunction (ED), the most commonly reported sexual problem for men, reduces the quality of life for both patients and their partners. Even when physiologically effective, long-term adherence to ED treatments is poor. We review here the implication of having patients’ partners involved in ED treatment, starting with treatment selection. We suggest that having partners engaged from the outset may promote an erotic association of the treatment with the partner, i.e., conceptually linking the aid to the sexual pleasure that the partner provides. We hypothesize that this erotic association should enhance the sexual aid’s effectiveness and might potentially help improve long-term adherence. The primary focus of this review, though, is non-pharmacological and non-surgical options for maintaining sexual activity for men with ED. Though not ED treatments per se, anecdotal data suggest that these options may be effective for some patients and their partners in regaining a satisfying sex life. The aids discussed include external penile prostheses, penile sleeves, and penile support devices. These devices can allow men to participate in penetrative sexual intercourse despite moderate to severe ED. External penile prostheses can be personalized so they match in size and shape a man’s normal full erection. Penile sleeves can similarly be customized with a lumen that fits best a patient’s penis for optimal tactile stimulation. We review how multi-sensory integration can enhance sexual arousal for men who use such devices, allowing them to achieve orgasm despite intractable ED. Patients are not always advised within ED clinics about these options nor why and how they can facilitate non-erection dependent sexual recovery. Clinicians need to be aware of these devices and their positive attributes, so they can objectively counsel and encourage couples to explore their use as an alternative to more invasive treatments. The most commonly promoted non-medical ED aid offered to patients is the vacuum erection device. We discuss how erections achieved with the vacuum erection device have a “hinge effect”, that is an underappreciated barrier to the effectiveness of the erection. With a hinged erection, the penis points downward rather than upward. We show how the normal kinematics of the penis during coitus is not strictly linear (i.e., not uniaxial; not just in-and-out), and is impeded by hinging. Positional adjustment, such as the receptive partner being on top, may help overcome this problem for some couples. Lastly, we suggest that, in the case where ED can be anticipated from a pending medical treatment, such as a prostatectomy, pre-habilitative approaches may potentially improve adherence to sexual aid use in the long-term. In conclusion, non-pharmacological and non-surgical options for sexual recovery are available. Scientific studies on the effectiveness of these interventions in restoring satisfying sex are warranted.

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Partner’s Perspective on Long-term Sexual Dysfunction After Prostate Cancer Treatment

Cited by 10 publications

References 28 publications

Psychosocial perspectives on sexual recovery after prostate cancer treatment

Psychosocial perspectives on sexual recovery after prostate cancer treatment

Social Support and Health-Related Quality of Life Among Gay and Bisexual Men With Prostate Cancer

Non-pharmacological and non-surgical strategies to promote sexual recovery for men with erectile dysfunction

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