Psychological Impacts of Male Sexual Dysfunction in Pelvic Cancer Survivorship

Twitchell, David K.; Wittmann, Daniela; Hotaling, James M.; Pastuszak, Alexander W.

doi:10.1016/j.sxmr.2019.02.003

Cited by 24 publications

(11 citation statements)

References 42 publications

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“…This finding clearly showed that a VAI ¼ 4.33 associated with a significant decrease in other sexual function scores, as in the erectile function score, possibly due to decreased self-esteem, in addition to low T levels, which is consistent with the previous studies. 31 Also, decrease in sexual function scores may be related to decreased T levels. In the present study, the T level was higher than the 8-nmol/L T level in the study conducted by Zitzmann et al 32 In clinical practice, there is a lack of consensus on what level of T justifies the diagnosis of hypoandrogenemia for symptomatic men.…”

Section: Discussionmentioning

confidence: 99%

Can High Visceral Adiposity Index Be a Risk Factor for Sexual Dysfunction in Sexually Active Men?

Bolat

Kocamanoglu

Ozbek

et al. 2020

The Journal of Sexual Medicine

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Background To our knowledge, there is no study in the literature that has investigated a cutoff value of the visceral adiposity index (VAI) for erectile dysfunction (ED) in men. Aim To show a possible relationship between ED and VAI levels representing adipose tissue dysfunction and to identify a cutoff value of the VAI for ED. Methods This prospective cross-sectional study included 276 participants in 5 groups: non-ED, mild ED, mild-moderate ED, moderate ED, and severe ED. The VAI was calculated. Fasting glucose, triglyceride, high-density lipoprotein, testosterone (T), prolactin, and estradiol were measured. Erectile function, sexual satisfaction, orgasm, desire, and general satisfaction scores were recorded using the International Index of Erectile Dysfunction 1–15 questionnaire. The participants were divided into BMI1 (<25.0), BMI2 (25–29.9), and BMI3 (>30.0) categories based on body mass index (BMI) and WC1 (<94 cm), WC2 (94–102 cm), and WC3 (>102 cm) categories based on waist circumference (WC). Outcomes The VAI was investigated as an independent risk factor for ED, compared with BMI and WC. Results The median VAI progressively increased, but a marked increase was recorded in groups 4 and 5 (P = .001). A significant increase in ED was observed for a VAI score higher than 4.33 (P = .001). Each integer increase of the VAI was associated with a 1.3-fold increased risk of ED. The odds ratio of ED for the VAI = 4.33 was 4.4 (P < .001). The WC and BMI significantly increased as the degree of ED increased (P = .001), but statistical analysis showed a significant decrease only in moderate and severe ED groups (P < .05). Starting from non-ED patients, serum triglyceride increased and high-density lipoprotein decreased progressively in all ED groups (P = .001). T/E2 slightly reduced as the severity of ED increased (P > .05). T decreased in ED groups (P = .022). Regardless of the ED level, other sexual subdomains decreased in ED patients (P = .001). The ED rates in 3 increasing BMI and WC categories were similar (P > .05). For VAI = 4.33, BMI ≥ 30.0 kg/m2, and WC > 102 cm, sensitivity and specificity were 61.2% and 73.8%, 31.6% and 90.5%, and 54.3% and 69.0%, respectively. Clinical Implications The VAI should be considered as a reliable independent risk factor for ED as a predictor of visceral adipose dysfunction. Strengths & Limitations The main strength is that this is the first study to investigate the association between the VAI and sexual dysfunction in men. The low number of participants is the limiting factor. Conclusion The findings suggest that the VAI can be used as a reliable independent risk factor marker for ED as a predictor of visceral adipose dysfunction.

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Section: Discussionmentioning

confidence: 99%

Can High Visceral Adiposity Index Be a Risk Factor for Sexual Dysfunction in Sexually Active Men?

Bolat

Kocamanoglu

Ozbek

et al. 2020

The Journal of Sexual Medicine

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“…Sexual health is an important quality-of-life issue in cancer patients and survivors. The negative effect of cancer and its treatment on sexual health are widely described in the literature [ 1 – 12 ]. Sexual side effects can affect patients regardless of age, gender or cancer site.…”

Section: Introductionmentioning

confidence: 99%

Can the provision of sexual healthcare for oncology patients be improved? A literature review of educational interventions for healthcare professionals

et al. 2020

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Purpose Sexual health is an important quality-of-life concern for cancer patients and survivors, but a difficult discussion topic for patients and healthcare professionals. The most important barriers causing healthcare professionals to avoid the topic are lack of education and lack of knowledge. How effective education about sexual health is for oncology healthcare professionals is not clear. The aim of this review is to examine the effectiveness of interventions in improving the provision of sexual healthcare for cancer patients. Methods A systematic literature review was conducted according to PRISMA guidelines using the following data sources: PubMed, PsychInfo, Embase and Emcare. Quantitative research was included which contained pre-intervention and post-intervention outcomes. The assessment of the studies was conducted independently by two reviewers. A third reviewer was involved if there was no consensus. Results Seven studies were included. In total, 572 oncology healthcare professionals participated, including physicians, nurses and allied healthcare professionals. Interventions consisted of 6 face-to-face sessions and one online program. Primary objectives of the studies were the assessment of improvement in knowledge about sexual health, improvement of practice, frequency of discussing sexual health and comfort level and the decline of perceived barriers to discussing sexual health. Studies showed that interventions resulted in improved realization of the objectives. Conclusions Although improvement in the knowledge of healthcare professionals was achieved, it was not possible to give an overall recommendation for the development of interventions due to the limited number of studies and heterogeneity of the data. Implications for Cancer Survivors Sexual health is an important area of survivorship that is often neglected. Many oncology healthcare professionals lack training and knowledge to provide such care. More evidence-based practices are needed to improve sexual healthcare for cancer survivors.

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“…The consequences of cancer treatment can influence all aspects of sexuality, including desire, satisfaction and functioning. Sexuality is considered an extremely important quality-of-life concern by cancer survivors [7][8][9]. Despite reporting concerns regarding their sexual function, patients are frequently not informed about how treatment may affect their sexual function [1,10,11].…”

Section: Introductionmentioning

confidence: 99%

Discussing Sexual Health in the Medical Oncologist’s Practice: Exploring Current Practice and Challenges

et al. 2019

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Sexuality is a significant quality-of-life concern for many cancer patients. Patients may be disadvantaged if they are not informed and not offered sexual health care. We sought to reveal oncologists' current practice and opinions concerning sexual counselling. The aim of this study was to explore the knowledge, attitude and practice patterns of Dutch medical oncologists regarding treatment-related sexual dysfunction. Questionnaires were sent to 433 members of the Dutch Society of Medical Oncology. The majority (81.5%) of the 120 responding medical oncologists (response rate 30.6%) stated they discussed sexual function with fewer than half of their patients. At the same time, 75.8% of the participating oncologists agreed that addressing sexual function is their responsibility. Sexual function was discussed more often with younger patients and patients with a curative treatment intent. Barriers for avoiding discussing sexual function were lack of time (56.1%), training (49.5%) and advanced age of the patient (50.4%). More than half (64.6%) stated they had little knowledge about the subject and the majority (72.9%) wanted to acquire additional training in sexual function counselling. Medical oncologists accept that sexual function counselling falls within their profession, yet they admit to not counselling patients routinely concerning sexual function. Only in a minority of cases do medical oncologists inform their patients about sexual side effects of treatment. Whether they counsel patients is related to how they view patient's prognosis, patient's age, and self-reported knowledge. Findings indicate there is a role for developing education and practical training.

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Psychological Impacts of Male Sexual Dysfunction in Pelvic Cancer Survivorship

Cited by 24 publications

References 42 publications

Can High Visceral Adiposity Index Be a Risk Factor for Sexual Dysfunction in Sexually Active Men?

Can High Visceral Adiposity Index Be a Risk Factor for Sexual Dysfunction in Sexually Active Men?

Can the provision of sexual healthcare for oncology patients be improved? A literature review of educational interventions for healthcare professionals

Discussing Sexual Health in the Medical Oncologist’s Practice: Exploring Current Practice and Challenges

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