AB048. Sexual function and QOL following pelvic surgery from alternative point of view

Background: Sexual dysfunction following pelvic surgeries remains a significant problem, although many nerve sparing techniques and penile rehabilitation protocols are proving helpful. Preserving and recovering erectile capacity after pelvic surgeries are critical for continued sexual activities. However, other factors may compromise successful sexual activity in post-operative life, such as low sexual motivation and negative sexual attitudes of patients and their partners. The goals of my lecture are to review influences of partner’s sexual attitudes on post-operative sexual life based on own study following radical prostatectomy and published papers.

Methods: One hundred and sixty two patients who underwent retropubic RP and their partners were evaluated. The patients’ sexual function (SF), bother (SB) and expectations for post-operative sexual life were assessed prospectively at baseline and 1, 3, 6, 12 months after RP. Questions for post-operative sexual life were asked for the partner before operation. SF and SB were evaluated with the University of California Los Angeles Prostate Cancer Index. Expectations for post-operative sexual life were studied using three ad-hoc questions.

Results: Rate of having sexual intercourse and adequate penile rigidity for vaginal penetration at baseline was 29.0%and 21.6%, respectively. A significantly higher rate of patients considered “sexual life is important” (patient: 35.2% partner: 13.0%), hoped for “preservation of erectile function” (patient: 66.0% partner: 33.3%) and accepted “use of PDE5-I” (patient: 65.4% partner: 43.2%) compared to their partners (P<0.001). Patients who had partners’ with a negative sexual attitude lost sexual motivation 1 year after operation. However, patients with cooperative partners’ maintained sexual motivation although they felt greater sexual bother 1 year after RP.

Conclusions: There was significant dissociation in perspectives for post-operative sexual life between the patients and partners. Partners’ low expectations were associated with patients’ low SB and motivation. Partners’ cooperative attitude might contribute to maintain patients’ sexual desire and motivation. I report this topic with some literature review.

Keywords: Sexual function (SF); pelvic surgery; sexual attitudes; sexual life