Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., #300, Minneapolis, MN, 55454, USA.
Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA.
Arch Sex Behav. 2020 Jul;49(5):1589-1600. doi: 10.1007/s10508-018-1360-y. Epub 2019 Apr 23.
Prostate cancer is the second most common cancer in gay, bisexual, and other men who have sex with men (GBM). Few studies have assessed the effects of treatment on GBM's sexual behavior. For an online survey, 193 gay and bisexual men with prostate cancer were recruited from the North American's largest online cancer support group. Sexual functioning was measured using the Expanded Prostate Cancer Index Composite (EPIC) and a tailored Gay Sexual Functioning Inventory (GSFI). GBM have worse EPIC urinary and hormonal function and worse hormonal bother, but better sexual function and bother scores than published norms. In the GSFI, two-thirds of participants described their sexual functioning, post-treatment, as fair to poor. Only 22% reported erections sufficient for insertive anal sex. For receptive anal sex, one-third met criteria for anodyspareunia. Over half reported urination problems during sex or at orgasm. Erectile difficulties were common, severe, and a reason cited for not using condoms. Three men HIV seroconverted post-prostate cancer treatment. Differences in function and bother scores were observed by type of treatment, age, race/ethnicity, sexual orientation, but not relationship status. Sexual functioning significantly predicted long-term mental and physical health. GBM scored significantly worse on mental health and better on physical health than published norms. Sexual recovery after prostate cancer treatment is problematic for most GBM. Research to develop more effective sexual recovery, tailored to the needs of GBM treated for prostate cancer, is needed. Six implications for clinicians treating GBM with prostate cancer are identified.
前列腺癌是男同性恋、双性恋和其他与男性发生性关系的男性（GBM）中第二常见的癌症。很少有研究评估治疗对 GBM 性行为的影响。为了进行在线调查，从北美最大的在线癌症支持组织中招募了 193 名患有前列腺癌的男同性恋和双性恋男性。使用扩展前列腺癌指数综合量表（EPIC）和专门的同性恋性功能量表（GSFI）来衡量性功能。GBM 的 EPIC 尿功能和激素功能以及激素困扰更差，但性功能和困扰评分好于公布的标准。在 GSFI 中，三分之二的参与者描述他们的性功能在治疗后为一般到差。只有 22%的人报告说勃起足以进行插入式肛交。对于接受性肛交，三分之一的人符合肛门疼痛的标准。超过一半的人报告在性行为或性高潮期间有排尿问题。勃起困难很常见，严重，并且是不使用避孕套的原因之一。三名男性在前列腺癌治疗后 HIV 血清转换。不同的治疗类型、年龄、种族/族裔、性取向观察到功能和困扰评分的差异，但关系状况没有差异。性功能显著预测长期的心理健康和身体健康。GBM 的心理健康评分明显低于公布的标准，身体健康评分则更好。前列腺癌治疗后，大多数 GBM 的性功能恢复存在问题。需要研究开发更有效的性功能恢复方法，以满足接受前列腺癌治疗的 GBM 的需求。确定了治疗前列腺癌的 GBM 的临床医生的六个影响。
