Department of Psychology and Neuroscience, Duke University, Durham, NC.
Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC.
Urol Oncol. 2022 Aug;40(8):359-365. doi: 10.1016/j.urolonc.2021.06.006. Epub 2021 Jul 8.
Provide an overview of sexual dysfunction in female urologic cancer patients, approaches for assessing sexual problems, and interventions to treat sexual dysfunction in this patient population.
A review of the literature in urologic oncology was conducted. Research on other female pelvic cancers with similar treatments was also reviewed.
Sexual health is an important element of women's quality of life that is often not discussed and problems remain unaddressed. Urologic cancer treatments commonly result in sexual dysfunction (e.g., dyspareunia, vaginal dryness, problems with orgasm) in female patients, although more research is necessary to understand the impact of non-surgical treatments (e.g., radiation, chemotherapy, immunotherapy). As such, provider teams should complete necessary screening for sexual dysfunction during and after treatment. The 5 A's model (i.e., Ask, Advise, Assess, Assist, Arrange Follow-Up) provides a helpful guide for communicating about and addressing sexual health concerns with patients during the screening process. If it is determined that referral for further assessment and treatment of sexual dysfunction is needed, a number of non-pharmacologic (e.g., pelvic floor physical therapy; psychosexual counseling) and pharmacologic treatment approaches are available.
Sexual dysfunction is common in female urologic cancer survivors. Routine assessment and appropriate referral are essential for high quality patient care.
概述女性泌尿科癌症患者的性功能障碍,评估性问题的方法以及针对该患者人群治疗性功能障碍的干预措施。
对泌尿科肿瘤学文献进行了回顾。还回顾了其他具有类似治疗方法的女性盆腔癌症的研究。
性健康是女性生活质量的重要组成部分,但通常未得到讨论,问题仍未得到解决。泌尿科癌症治疗通常会导致女性患者出现性功能障碍(例如性交困难,阴道干燥,性高潮问题),尽管还需要更多的研究来了解非手术治疗(例如放射治疗,化学疗法,免疫疗法)的影响。因此,提供者团队应在治疗期间和治疗后完成对性功能障碍的必要筛查。5A 模型(即询问,建议,评估,协助和安排随访)为在筛查过程中与患者交流和解决性健康问题提供了有用的指南。如果确定需要进一步评估和治疗性功能障碍,则可以使用多种非药物治疗方法(例如骨盆底物理疗法;性心理咨询)和药物治疗方法。
性功能障碍在女性泌尿科癌症幸存者中很常见。常规评估和适当转介对于高质量的患者护理至关重要。