Patient Age, Co-morbidities and Psychosexual Concerns

Abstract

There are two cohorts that need to be taken into account-the younger and older patients when thinking about erectile function after robotic surgery. O’Brien et al., [1] touches on this (Level 2b, recommendation C). The younger patients are actually more vocal. The older patients, as highlighted by O’Brien et al., [1], may actually be more embarrassed and not ask for help, or forgo erectile function entirely [1]. This is re-enforced by other research. Kimura et al., [2] (n = 319) found patients with psychosexual impairment, despite having operations were more likely to be older and not seek help (Level 2b, recommendation B) [2]. This is again re-enforced by Becker et al., [3], who then goes onto show the degree of impairment of erectile function drops, in younger and older cohorts [3]. The study is important, as the drop is double in older patients, yet they may not be as vocal, which clearly needs to be addressed as part of a psychosexual pathway (Level 2b, recommendation A). These results were re-enforced by Tewari et al., [4] Level 2c, recommendation A) [4] (n = 224).