Department of Urology and Andrology, Robert Debré Academic Hospital, Reims, France.
Int J Impot Res. 2011 Mar-Apr;23(2):81-6. doi: 10.1038/ijir.2011.8. Epub 2011 Apr 7.
The life expectancy of patients with localized prostate cancer at treatment initiation has increased, and post-treatment quality of life has become a key issue. The aim of this study is to assess the impact of Radical prostatectomy (RP) on patients' sexual health and satisfaction according to sexual motivation using a self-administered questionnaire completed by two groups of RP patients, with high or lower levels of sexual motivation. A total of 63 consecutive patients were included (mean age, 63.9 years), of whom 74.6% were being treated for erectile dysfunction (ED). After RP, patients reported lower sexual desire (52.4%), reduced intercourse frequency (79.4%), anorgasmia (39.7%), less satisfying orgasm (38.1%), climacturia (25.4%), greater distress (68.3%) and/or lower partner satisfaction (56.5%). Among the most sexually motivated patients, 76.0% reported loss of masculine identity, 52% loss of self-esteem and 36.0% anxiety about performance. These rates were lower among less motivated patients (52.6, 28.9, and 18.4%, respectively). Mean overall satisfaction score was 4.8 ± 2.9. The score was significantly lowered in motivated than less motivated patients (3.4 vs 5.8) (P = 0.001). In conclusion, RP adversely affected erectile and orgasmic functions but also sexual desire, self-esteem and masculinity. The more motivated patients experienced greater distress and were less satisfied.
治疗伊始局限性前列腺癌患者的预期寿命有所延长，而治疗后的生活质量已成为关键问题。本研究旨在评估根据性动机使用自我管理问卷对两组接受根治性前列腺切除术（RP）的前列腺癌患者的性功能和满意度的影响，两组患者的性动机水平有高有低。共纳入 63 例连续患者（平均年龄 63.9 岁），其中 74.6%的患者因勃起功能障碍（ED）接受治疗。RP 后，患者报告性欲降低（52.4%）、性交频率降低（79.4%）、无快感（39.7%）、快感不满足（38.1%）、性高潮后尿失禁（25.4%）、更大的困扰（68.3%）和/或伴侣满意度降低（56.5%）。在最有性动机的患者中，76.0%报告失去男子气概，52%报告自尊心下降，36.0%报告对表现的焦虑。在动机较低的患者中，这些比率分别为 52.6%、28.9%和 18.4%。总体满意度平均得分为 4.8±2.9。与动机较低的患者相比，动机较强的患者评分明显较低（3.4 与 5.8）（P=0.001）。结论：RP 不仅会影响勃起和射精功能，还会影响性欲、自尊心和男子气概。性动机较强的患者困扰更大，满意度更低。
