Lee Tsz Kin, Handy Ariel Baker, Kwan Winkle, Oliffe John Lindsay, Brotto Lori Anne, Wassersug Richard Joel, Dowsett Gary Wayne
British Columbia Cancer Agency, Fraser Valley Cancer Centre, Surrey, BC, Canada.
Department of Obstetrics and Gynaecology, Diamond Health Care Centre, University of British Columbia, Vancouver, BC, Canada.
J Sex Med. 2015 Dec;12(12):2378-86. doi: 10.1111/jsm.13030. Epub 2015 Nov 4.
With earlier prostate cancer (PCa) diagnosis and an increased focus on survivorship, post-treatment sexual quality of life (QoL) has become increasingly important. Research and validated instruments for sexual QoL assessment based on heterosexual samples have limited applicability for men-who-have-sex-with-men (MSM).
We aimed to create a validated instrument for assessing sexual needs and concerns of MSM post-PCa treatment. Here we explore post-PCa treatment sexual concerns for a sample of MSM, as the first part of this multi-phase project.
Individual semi-structured interviews were conducted with 16 MSM face-to-face or via Internet-based video conferencing. Participants were asked open-ended questions about their experiences of sexual QoL following PCa. Interviews were recorded, transcribed verbatim, uploaded to NVivo 8(TM) , and analyzed using qualitative methodology.
We have conducted semi-structure qualitative interviews on 16 MSM who were treated for PCa. Focus was on post-treatment sexual concerns.
The following themes were inductively derived: (i) erectile, urinary, ejaculation, and orgasmic dysfunctions; (ii) challenges to intimate relationships; and (iii) lack of MSM-specific oncological and psychosocial support for PCa survivorship. Sexual practices pre-treatment ranked in order of frequency were masturbation, oral sex, and anal sex, an ordering that prevailed post-treatment. Sexual QoL decreased with erectile, urinary, and ejaculation dysfunctions. Post-treatment orgasms were compromised. Some single men and men in non-monogamous relationships reported a loss of confidence or difficulty meeting other men post-treatment. Limited access to targeted oncological and psychosocial supports posed difficulties in coping with PCa for MSM.
The negative impact on sexual QoL can be severe for MSM and requires targeted attention. Penile-vaginal intercourse and erectile function have been the primary focus of sexual research and rehabilitation for men with PCa, and do not adequately reflect the sexual practices of MSM. Our findings suggest that future research dedicated to MSM with PCa is needed to incorporate their sexual practices and preferences specifically into treatment decisions, and that targeted oncological and psychosocial support services are also warranted.
随着前列腺癌（PCa）诊断的提前以及对生存质量关注度的提高，治疗后性生活质量（QoL）变得愈发重要。基于异性恋样本的性生活质量评估研究及经过验证的工具，对男男性行为者（MSM）的适用性有限。
我们旨在创建一种经过验证的工具，用于评估男男性行为者前列腺癌治疗后的性需求和担忧。在此，我们探索男男性行为者样本在前列腺癌治疗后的性担忧，作为这个多阶段项目的第一部分。
对16名男男性行为者进行了个人半结构化访谈，通过面对面或基于互联网的视频会议进行。参与者被问及关于前列腺癌后性生活质量经历的开放式问题。访谈进行了录音，逐字转录，上传至NVivo 8（商标），并采用定性方法进行分析。
我们对16名接受前列腺癌治疗的男男性行为者进行了半结构化定性访谈。重点是治疗后的性担忧。
归纳出以下主题：（i）勃起、排尿、射精和性高潮功能障碍；（ii）亲密关系面临的挑战；（iii）缺乏针对男男性行为者前列腺癌幸存者的肿瘤学和心理社会支持。治疗前性行为的频率排序为手淫、口交和肛交，这种排序在治疗后依然存在。性生活质量随着勃起、排尿和射精功能障碍而下降。治疗后的性高潮受到影响。一些单身男性和处于非一夫一妻制关系中的男性报告称，治疗后自信心丧失或难以结识其他男性。获得针对性的肿瘤学和心理社会支持有限，给男男性行为者应对前列腺癌带来了困难。
对男男性行为者的性生活质量负面影响可能很严重，需要有针对性的关注。阴茎 - 阴道性交和勃起功能一直是前列腺癌男性性研究和康复的主要关注点，并未充分反映男男性行为者的性行为。我们的研究结果表明，未来需要针对患有前列腺癌的男男性行为者开展研究，将他们的性行为和偏好具体纳入治疗决策，并且也需要有针对性的肿瘤学和心理社会支持服务。
