Namiki Shunichi, Arai Yoichi
Department of Urology Osaki City Hospital Osaki Japan.
Department of Urology Tohoku University Graduate School of Medicine 1-1 Seiryomachi, Aoba-ku 980-8574 Sendai Japan.
Reprod Med Biol. 2011 Feb 16;10(2):59-68. doi: 10.1007/s12522-011-0076-7. eCollection 2011 Jun.
Race and ethnicity are important factors in health-related quality of life (QOL) because of racial differences in preferences for, and trust in, health systems. Such factors are likely to affect QOL and patient satisfaction with care.
Using a self-reported questionnaire, Japanese men with prostate cancer reported lower sexual function scores at baseline. In detail, Japanese men were more likely than American men to report poor sexual desire, poor erection ability, poor overall ability to function sexually, poor ability to attain orgasm, poor quality of erections, infrequency of erections, infrequency of morning erections, and intercourse in the previous 4 weeks. However, Japanese men were less likely than American men to be concerned about their sexual function. Two years after surgery, American patients were more likely than Japanese patients to regain their baseline sexual function. The use of phosphodiesterase-5 (PDE-5) inhibitors has been widely publicized as the solution to erectile dysfunction after prostate cancer treatment. Although PDE-5 inhibitors have been available in Japan since 1999, it is striking that Japanese men with localized prostate cancer are much less likely (only 10%) to use PDE-5 inhibitors than American men.
Japanese patients with localized prostate cancer report worse sexual function but are less concerned about their reduced function. In the absence of a biological explanation for such differences, however, we suspect that cultural differences may explain the differences between QOL survey results from Japanese or American men with prostate cancer.
种族和民族是影响健康相关生活质量（QOL）的重要因素，因为不同种族对医疗系统的偏好和信任存在差异。这些因素可能会影响生活质量和患者对医疗护理的满意度。
通过一份自我报告问卷，患有前列腺癌的日本男性在基线时报告的性功能得分较低。具体而言，与美国男性相比，日本男性更有可能报告性欲低下、勃起能力差、整体性功能差、达到性高潮的能力差、勃起质量差、勃起频率低、晨勃频率低以及在过去4周内无性交。然而，与美国男性相比，日本男性对自己性功能的担忧较少。手术后两年，美国患者比日本患者更有可能恢复到基线性功能水平。磷酸二酯酶-5（PDE-5）抑制剂的使用已被广泛宣传为前列腺癌治疗后勃起功能障碍的解决方案。尽管PDE-5抑制剂自1999年起在日本就已上市，但令人惊讶的是，患有局限性前列腺癌的日本男性使用PDE-5抑制剂的可能性比美国男性低得多（仅为10%）。
患有局限性前列腺癌的日本患者报告的性功能较差，但对其功能下降的担忧较少。然而，在缺乏对此类差异的生物学解释的情况下，我们怀疑文化差异可能解释了日本或美国前列腺癌男性生活质量调查结果之间的差异。
