Rosser B R Simon, Kohli Nidhi, Bates Alex J, Talley Kristine M C, Wright Morgan M, Polter Elizabeth J, Wheldon Christopher W, Haggart Ryan, Dickstein Daniel R, Ross Michael W, Zhang Ziwei, West William, Konety Badrinath R
Division of Epidemiology & 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, 250 Education Sciences Bldg, 56 E River Rd, Minneapolis, MN, 55455, USA.
J Cancer Surviv. 2024 Sep 12. doi: 10.1007/s11764-024-01672-6.
Sexual minority prostate cancer patients have worse health-related quality of life outcomes than heterosexual patients. We conducted the first study to test whether sexual and urinary rehabilitation tailored for sexual minority patients was acceptable, feasible, and efficacious at improving their sexual and urinary function.
Restore-2 was a 24-month randomized controlled trial of an online biopsychobehavioral rehabilitation study for sexual minority men treated for prostate cancer experiencing sexual and/or urinary problems. Participants were 401 US sexual minority men treated for prostate cancer and experiencing sexual and/or urinary problems at baseline. Intervention components included phosphodiesterase-5 inhibitors, sexual aids, a pelvic floor exercise regimen and video, a guide to good gay sex following treatment, and coaching. Quality of life assessments were completed at baseline, 3, 6, 12, 18, and 24 months.
We confirmed good acceptability and feasibility, but only minimal improvement was observed over time and no differences were found between treatment and control arms.
We found no evidence that the intervention improved sexual or urinary outcomes for participants. However, we confirmed excellent acceptability and feasibility for a sexual rehabilitation program tailored to sexual minority participants. In addition, participants reported enduring usage and acceptability of sexual aids (including vacuum pump, anal dilators, and penile constriction rings) as well as masturbation and pelvic floor exercises to accommodate their sexual challenges.
Sexual "accommodation," rather than "rehabilitation," may be a more accurate and realistic goal for this population. Patients should be provided sexual aids to help accommodate their sexual and urinary challenges.
This study was retrospectively registered with ClinicalTrials.gov, study number: NCT03923582; date: 22/04/2019.
性少数群体前列腺癌患者的健康相关生活质量结果比异性恋患者更差。我们开展了第一项研究，以测试针对性少数群体患者量身定制的性与泌尿康复方案在改善其性功能和泌尿功能方面是否可接受、可行且有效。
Restore-2是一项为期24个月的随机对照试验，针对患有前列腺癌且有性和/或泌尿问题的性少数群体男性开展在线生物心理行为康复研究。参与者为401名接受过前列腺癌治疗且在基线时存在性和/或泌尿问题的美国性少数群体男性。干预措施包括磷酸二酯酶-5抑制剂、性辅助器具、盆底肌锻炼方案及视频、治疗后良好男同性恋性行为指南以及指导。在基线、3个月、6个月、12个月、18个月和24个月时完成生活质量评估。
我们证实了该方案具有良好的可接受性和可行性，但随着时间推移仅观察到极小的改善，且治疗组与对照组之间未发现差异。
我们没有发现证据表明该干预措施改善了参与者的性或泌尿结局。然而，我们证实了针对性少数群体参与者量身定制的性康复方案具有出色的可接受性和可行性。此外，参与者报告了性辅助器具（包括真空泵、肛门扩张器和阴茎收缩环）以及手淫和盆底肌锻炼在应对其性挑战方面的持续使用情况和可接受性。
对于这一群体而言，性“适应”而非“康复”可能是一个更准确和现实的目标。应向患者提供性辅助器具，以帮助他们应对性和泌尿方面的挑战。
本研究已在ClinicalTrials.gov进行回顾性注册，研究编号：NCT03923582；日期：2019年4月22日。
