Minchaca C, Adjakidjé P, Gbotounou N, Gassette C, Mormain L, Perrochaud A, Rose M, Merle S, Almont T, Blanchet P
Service clinique de chirurgie urologique, CHU de Martinique, 97232 Le Lamentin, Martinique.
Service clinique de chirurgie urologique, CHU de Martinique, 97232 Le Lamentin, Martinique.
Fr J Urol. 2025 Mar;35(2):102797. doi: 10.1016/j.fjurol.2024.102797. Epub 2024 Oct 28.
Curative surgery for localized prostate cancer can lead to iatrogenic erectile dysfunction (ED), affecting couples. Sexuality remains influenced by social norms, often requiring men to provide pleasure through rigid erections. However, iatrogenic ED does not prevent male orgasm, although it can disrupt body image and self-esteem. This study aims to describe couples' sexual repertoire and partners' sexual satisfaction post-radical prostatectomy at the Centre Hospitalier Universitaire de Martinique.
A monocentric retrospective observational study was conducted with data collected from January 2021 to March 2024. The Valentin and ASEX questionnaires were administered to the partners of future vesiculo-prostatectomy patients at the start of the sex-rehabilitation program. Responses were analyzed anonymously using the Sphinx iQ2 application.
The characteristics of the population were described in terms of proportions and means, with a significance threshold set at 0.05 for statistical tests. Of the 152 couples identified, 65 Valentine questionnaires were available. Respondents were heterosexual women, with an average age of 59, and their partners had an average age of 64. Non-penetrative sex was already part of the sexual repertoire for 52% of couples prior to prostate cancer diagnosis. After surgery, 32% of partners resumed penetrative sex, while 43% had not yet resumed sexual intimacy, and 14% had resumed non-penetrative sex. Mutual fondling (85%), vaginal penetration (70%), female oro-genital sex (70%) and male oro-genital sex (52%) were the most popular sexual stimuli.
Surgery was therefore no obstacle to sexual satisfaction for our respondents, with a satisfaction level of 90% before and 86% after total prostatectomy. The same applies to orgasm before and after total prostatectomy. The results show that erectile dysfunction is not an obstacle to partners' sexual satisfaction, with couples able to reinvent their sexuality around non-penetrative practices. Sexual satisfaction indicators before and after RA show a strong correlation, confirming that surgery does not negatively affect sexual satisfaction.
The results show that men suffering from post-RP ED can free themselves from the dogma of penile erection by exploring female sexual pleasure to a greater extent. Couples practicing non-penetrative sexuality report satisfying, more playful, complicit and varied sexuality. Finally, ED has less of an impact on partners than future operators believe.
局限性前列腺癌的根治性手术可导致医源性勃起功能障碍（ED），影响夫妻生活。性观念仍受社会规范影响，通常要求男性通过坚挺勃起提供性快感。然而，医源性ED虽会破坏身体形象和自尊，但并不妨碍男性达到性高潮。本研究旨在描述马提尼克大学中心医院根治性前列腺切除术后夫妻的性模式及伴侣的性满意度。
进行了一项单中心回顾性观察研究，收集了2021年1月至2024年3月的数据。在性康复计划开始时，向未来膀胱前列腺切除术患者的伴侣发放了瓦伦丁问卷和ASEX问卷。使用Sphinx iQ2应用程序对回答进行匿名分析。
用比例和均值描述了人群特征，统计检验的显著性阈值设定为0.05。在确定的152对夫妻中，有65份瓦伦丁问卷可用。受访者为异性恋女性，平均年龄59岁，其伴侣平均年龄64岁。在前列腺癌诊断之前，52%的夫妻已经将非插入式性行为纳入性模式。手术后，32%的伴侣恢复了插入式性行为，43%尚未恢复性亲密关系，14%恢复了非插入式性行为。相互抚摸（85%）、阴道插入（70%）、女性口交（70%）和男性口交（52%）是最受欢迎的性刺激方式。
因此，手术对我们的受访者的性满意度并非障碍，前列腺全切术前的满意度为90%，术后为86%。前列腺全切术前和术后的性高潮情况也是如此。结果表明，勃起功能障碍并非伴侣性满意度的障碍，夫妻能够围绕非插入式性行为重新塑造他们的性体验。根治性前列腺切除术前和术后的性满意度指标显示出很强的相关性，证实手术不会对性满意度产生负面影响。
结果表明，患有前列腺切除术后勃起功能障碍的男性可以通过更大程度地探索女性性快感，摆脱阴茎勃起的教条。进行非插入式性行为的夫妻报告了令人满意、更有趣、默契且多样的性生活。最后，勃起功能障碍对伴侣的影响比未来的手术医生认为的要小。
