University of Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University Hospital of Cologne, Cologne, Germany.
Australian Catholic University, Mary MacKillop Institute for Health Research, Melbourne, Australia.
J Sex Med. 2021 Nov;18(11):1899-1914. doi: 10.1016/j.jsxm.2021.09.001. Epub 2021 Oct 13.
Emerging evidence suggests that exercise interventions may improve sexual dysfunction, one of the most common and distressing long-term adverse effects of cancer treatment.
The aim of this systematic review is to provide an overview of the effects of exercise on sexual dysfunction in prostate cancer patients.
A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. The systematic literature search was performed on 13th July 2021 using CINAHL, Cochrane Central Register of Controlled Trials, Embase, Medline and Web of Science. Studies were included if they were randomized controlled trials (RCTs) assessing sexual function in prostate cancer patients conducting an exercise intervention alone or in combination with other supportive interventions. The methodological quality was assessed using the Physiotherapy Education Database Score and Jadad scale. Outcomes were reported as between-group differences. Intragroup differences were also reported if significant.
Positive intervention effects on sexual function were primarily observed in patients following prostatectomy and undergoing anti-hormone treatment and for pelvic floor muscle exercises as well as aerobic and resistance exercise.
22 RCTs (n = 1.752 patients) met the eligibility criteria, conducting either an exercise-only intervention (n = 10), a multimodal (exercise plus other supportive therapy) intervention (n = 4), or pelvic floor muscle exercises (n = 8). 6 RCTs assessed sexual dysfunction as a primary endpoint and 8 RCTs used dedicated assessment methods. 9 of the 22 RCTs found significant between-group differences in favor of the intervention group.
The multifaceted etiology of sexual dysfunction provides a strong rationale to further investigate the effects of exercise on sexual dysfunction in prostate cancer patients and also to consider a multidisciplinary approach.
A strength is the comprehensive literature search to identify RCTs involving different exercise interventions and a wide range of sexual function assessments. Further, this is the first systematic review on this topic. The main limitations include the difficulty to compare studies due to the heterogeneity of exercise interventions and low questionnaire completion rates in some studies.
Preliminary data from a small number of studies suggest that certain exercise interventions may improve sexual dysfunction in prostate cancer patients, however further trials involving sexual dyfunction as a primary outcome and more comprehensive assessment tools are needed to confirm the rehabilitative and preventive effects of exercise on sexual dysfunction in prostate cancer patients. Nadine Reimer, Eva Maria Zopf, Rebecca Böwe, et al. Effects of Exercise on Sexual Dysfunction in Patients With Prostate Cancer - A Systematic Review. J Sex Med 2021;18:1899-1914.
新出现的证据表明，运动干预可能改善性功能障碍，这是癌症治疗后最常见和最令人痛苦的长期不良反应之一。
本系统评价旨在概述运动对前列腺癌患者性功能障碍的影响。
根据系统评价和荟萃分析首选报告项目的规定进行系统评价。系统文献检索于 2021 年 7 月 13 日在 CINAHL、Cochrane 对照试验中心注册、Embase、Medline 和 Web of Science 上进行。如果研究是评估前列腺癌患者单独进行运动干预或结合其他支持性干预的性功能的随机对照试验（RCT），则将其纳入。使用物理治疗教育数据库评分和 Jadad 量表评估方法学质量。结果报告为组间差异。如果有显著差异，也报告组内差异。
主要观察到前列腺切除术和抗激素治疗后以及骨盆底肌肉运动以及有氧运动和阻力运动后的患者的干预效果具有积极影响。
初步数据来自少数研究，表明某些运动干预可能改善前列腺癌患者的性功能障碍，但需要更多涉及性功能障碍作为主要结局的试验以及更全面的评估工具，以确认运动对前列腺癌患者性功能障碍的康复和预防作用。Nadine Reimer、Eva Maria Zopf、Rebecca Böwe 等人。运动对前列腺癌患者性功能障碍的影响-系统评价。J 性医学 2021;18:1899-1914。
