Patient Age, Co-morbidities and Psychosexual Concerns

  • Sanchia S. Goonewardene
  • Raj Persad
Chapter

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).

References

  1. 1.
    O’Brien R, Rose P, Campbell C, Weller D, Neal RD, Wilkinson C, McIntosh H, Watson E. “I wish I’d told them”: a qualitative study examining the unmet psychosexual needs of prostate cancer patients during follow-up after treatment. Patient Educ Couns. 2011;84:200–7.CrossRefGoogle Scholar
  2. 2.
    Kimura M, Bañez LL, Polascik TJ, Bernal RM, Gerber L, Robertson CN, Donatucci CF, Moul JW. Sexual bother and function after radical prostatectomy: predictors of sexual bother recovery in men despite persistent post-operative sexual dysfunction. Andrology. 2013;1(2):256–61.CrossRefGoogle Scholar
  3. 3.
    Becker A, Tennstedt P, Hansen J, Trinh QD, Kluth L, Atassi N, Schlomm T, Salomon G, Haese A, Budaeus L, Michl U, Heinzer H, Huland H, Graefen M, Steuber T. Functional and oncological outcomes of patients aged <50 years treated with radical prostatectomy for localised prostate cancer in a European population. BJU Int. 2014;114:38–45.CrossRefGoogle Scholar
  4. 4.
    Tewari A, Grover S, Sooriakumaran P, Srivastava A, Rao S, Gupta A, Gray R, Leung R, Paduch DA. Nerve sparing can preserve orgasmic function in most men after robotic-assisted laparoscopic radical prostatectomy. BJU Int. 2012;109:596–602.CrossRefGoogle Scholar
  5. 5.
    Jones LW, Hornsby WE, Freedland SJ, Lane A, West MJ, Moul JW, Ferrandino MN, Allen JD, Kenjale AA, Thomas SM, Herndon IJE, Koontz BF, Chan JM, Khouri MG, Douglas PS, Eves ND. Effects of nonlinear aerobic training on erectile dysfunction and cardiovascular function following radical prostatectomy for clinically localized prostate cancer. Eur Urol. 2014;65:852–5.CrossRefGoogle Scholar
  6. 6.
    Miner MM. Erectile dysfunction: a harbinger for cardiovascular events and other comorbidities, thereby allowing a ‘window of curability’. Int J Clin Pract. 2009;63:1123–6.CrossRefGoogle Scholar
  7. 7.
    Teloken PE, Nelson CJ, Karellas M, Stasi J, Eastham J, Scardino PT, Mulhall JP. Defining the impact of vascular risk factors on erectile function recovery after radical prostatectomy. BJU Int. 2013;111:653–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Sanchia S. Goonewardene
    • 1
  • Raj Persad
    • 2
  1. 1.The Royal Free Hospital and UCLLondonUnited Kingdom
  2. 2.North Bristol NHS TrustBristolUnited Kingdom

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