Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
J Sex Med. 2012 Oct;9(10):2724-32. doi: 10.1111/j.1743-6109.2012.02897.x. Epub 2012 Sep 18.
Erectile dysfunction (ED) is one of the most frequent sources of distress after treatment for prostate cancer (PCa), yet evidence suggests that men do not easily adjust to loss of sexual function over time. A hypothesized determinant of men's adaptation to ED is the degree to which they experience a loss of masculine identity in the aftermath of PCa treatment.
The aims of this study were (i) to describe the prevalence of concerns related to diminished masculinity among men treated for localized PCa; (ii) to determine whether diminished masculinity is associated with sexual bother, after controlling for sexual functioning status; and (iii) to determine whether men's marital quality moderates the association between diminished masculinity and sexual bother.
We analyzed cross-sectional data provided by 75 men with localized PCa who were treated at one of two cancer centers. Data for this study were provided at a baseline assessment as part of their enrollment in a pilot trial of a couple-based intervention.
The sexual bother subscale from the Prostate Health-Related Quality-of-Life Questionnaire and the Masculine Self-Esteem and Marital Affection subscales from Clark et al's PCa-related quality-of-life scale.
Approximately one-third of men felt they had lost a dimension of their masculinity following treatment. Diminished masculinity was the only significant, independent predictor of sexual bother, even after accounting for sexual functioning status. The association between diminished masculinity and sexual bother was strongest for men whose spouses perceived low marital affection.
Diminished masculinity is a prominent, yet understudied concern for PCa survivors. Regardless of functional status, men who perceive a loss of masculinity following treatment may be more likely to be distressed by their ED. Furthermore, its impact on adjustment in survivorship may rely on the quality of their intimate relationships.
勃起功能障碍（ED）是前列腺癌（PCa）治疗后最常见的困扰之一，但有证据表明，男性随着时间的推移不容易适应性功能的丧失。男性对 ED 适应的一个假设决定因素是他们在 PCa 治疗后丧失男性身份的程度。
本研究的目的是：（i）描述接受局限性 PCa 治疗的男性对男性气概减弱的担忧程度；（ii）确定在控制性功能状态后，男性气概减弱是否与性困扰相关；（iii）确定男性的婚姻质量是否调节了男性气概减弱与性困扰之间的关联。
我们分析了 75 名在两家癌症中心之一接受治疗的局限性 PCa 男性提供的横断面数据。这项研究的数据是作为他们参加一项夫妻为基础的干预试验的一部分在基线评估时提供的。
前列腺健康相关生活质量问卷的性困扰子量表和 Clark 等人的 PCa 相关生活质量量表的男性自我尊重和婚姻感情子量表。
大约三分之一的男性在治疗后感到自己失去了男性气概的一个方面。男性气概减弱是性困扰的唯一显著独立预测因素，即使在考虑到性功能状态后也是如此。对于配偶感知婚姻感情较低的男性，男性气概减弱与性困扰之间的关联最强。
男性气概减弱是 PCa 幸存者一个突出但研究不足的问题。无论功能状态如何，治疗后感到男性气概丧失的男性可能更容易因 ED 而感到困扰。此外，其对生存适应的影响可能取决于他们亲密关系的质量。
