Individual and Couple Side-Effects After Radical Prostatectomy: Personal Reflections from a Research Scientist
Abstract
Objectives: To provide medical staff who provide support to prostate cancer patients more detailed information on how side effects are experienced by those patients as well as the limitations of generally recommended treatments from the perspective of a patient who is also a research scholar. As the author experienced side-effects, it became apparent that side-effects and their treatments were more complex than he had been informed prior to his treatment. Some medical staff may not know as much as they should about such details, limiting their ability to help patients in their recovery from radical protatectomy.
Methods: As a qualitative study, throughout four years after experiencing radical prostatectomy, the author kept notes on his experiences, and those of acquaintances who had the same surgery about the same time, with bowel, urinary, and sexual side effects of the procedure, how those effects changed over time, and varying results obtained from recommended treatments. At the same time, the method was enhanced by a review of numerous books and scientific articles for related material on side-effects and their treatment that were relevant to the author’s experiences.
Results: There are some positive outcomes from radical prostatectomy other than the cure of cancer; however, negative side-effects were more prevalent. Most of those with whom the author discussed their side-effects reported disappointment, regardless of their source of treatment, because of their limited success in managing at least some of the side effects, especially sexual side-effects. Some of the recommended treatments require greater knowledge for successful implementation than often provided by medical staff. Overcoming side-effects often requires support from the cancer patient’s partner or family and may not be achievable without that support. Several scales to measure aspects of these issues were developed but remain to be tested for reliability and validity.
Conclusions: Patients need more detailed information on side-effects prior to selecting a treatment method so they can make more informed choices for their own treatments. More detailed information is needed on how to implement treatments for side-effects as well as involvement of their partners and family in dealing with side-effects, especially sexual side-effects. In terms of future research, there is a need for improved measurement of the side-effects of cancer treatment as well as potential family support during/after treatment.
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Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin 2019; 69(11): 7-34.
Prostate Cancer Foundation. Prostate cancer patient guide. Santa Monica, CA: Author, 2019.
Mandel P, Preisser F, Graefen M, Steuber T, Salomon G, Haese A, et al. High chance of late recovery of urinary and erectile function beyond 12 months after radical prostatectomy. Eur Urol. 2017; 71: 848-850.
Luiting HB, Roobol MJ. The use of PSA, biomarkers, risk calculators and mpMRI in the early detection of prostate cancer. Int Med Rev. 2019; 5(1): 1-20.
Carroll PR. Prostate disorders. Berkeley, CA: School of Public Health, University of California, Berkeley, 2020.
Ellsworth, P. 100 questions and answers about prostate cancer (3rd. Ed.). Burlington, MA: Jones & Bartlett Learning, 2013.
Martel T, Pompe RS, Bandini M, Marchioni M, Smith A, Bondarenko HD, et al. Radical prostatectomy in metastatic prostate cancer: a systematic review. Int Med Rev. 2017; 3(6): 1-9.
Sridhar AN, Cathcart PJ, Yap T, Hines J, Nathan S, Briggs TP, et al. Recovery of baseline erectile function in men following radical prostatectomy for high-risk cancer: a prospective analysis using validated measures. J Sex Med 2016; 13: 435-443.
Nguyen LN, Head L, Witiuk K, Punjani N, Mallick R, Cnossen S, et al. The risks and benefits of cavernous neurovascular bundle sparing during radical prostatectomy: a systematic review and meta-analysis. J. Urol. 2017; 198: 760-769.
Schumm WR. The long-term sexual and urological side effects of surgical removal of the prostate for cancer: A personal perspective from a research scientist. In An ebook on sexual medicine (pp. 1-26). Las Vegas, NV: Openaccessebooks, 2019.
Zaider T, Manne S, Nelson C, Mulhall J, Kissane D. Loss of masculine identity, marital affection, and sexual bother in men with localized prostate cancer. J Sex Med 2012; 9: 2724-2732.
Rossi MS, Moschini M, Bianchi M, Gandaglia G, Fossati N, Dell’Oglio P, et al. Erectile function recovery after nerve-sparing radical prostatectomy for prostate cancer: is back to baseline status enough for patient satisfaction? J Sex Med 2016; 13: 669-678.
Hermann B. Your body, your emotions, your relationship: an interactive guide for understanding sex, relationships, and cancer. Zion, IL: Cancer Treatment Centers of America, 2018.
Glickman, L, Godoy G, Lepor H. Changes in continence and erectile function between 2 and 4 years after radical prostatectomy. J Urology 2009; 181: 731-735.
Lee TK, Handy AB, Kwan W, Oliffe JL, Brotto LA, Wassersug RJ et al. Impact of prostate cancer treatment on the sexual quality of life for men-who-have-sex-with-men. J Sex Med. 2015; 12: 2378-2386.
Frey AU, Sonksen J, Fode M. Neglected side effects after radical prostatectomy: a systematic review. J Sex Med 2014; 11: 374-385.
Nelson JB. The ongoing challenge of urinary incontinence after radical prostatectomy. J. Urol. 2017; 198: 1223-1225.
Penson DF, McLerran D, Feng Z, Li L, Albertsen PC, Gilliland FD, et al. 5-year urinary and sexual outcomes after radical prostatectomy: results from the prostate cancer outcomes study. J. Urol. 2005; 173: 1701-1705.
Michl U., Tennstedt P, Feldmeier L, Mandel P, Oh SJ, Ahyai, S, et al. Nerve-sparing surgery technique, not the preservation of the neurovascular bundles, leads to improved long-term continence rates after radical prostatectomy. Eur Urol. 2016; 69: 584-589.
FC&A Medical Publishing. Your prostate answer book. Peachtree City, GA: Author, 2012.
Kretschmer A, Nitti V. Surgical treatment of male postprostatectomy incontinence: current concepts. Eur Urol. 2017; 3(4-5): 364-376.
Tai R, Alphs, HH, Krebs P, Nelson CJ, Mulhall JP. Erectile function recovery rate after radical prostatectomy: a meta-analysis. J Sex Med. 2009; 6: 2538-2546.
Prostate Cancer Foundation. Prostate cancer patient guide. Santa Monica, CA: Author, 2017.
Mulhall JP. Defining and reporting erectile function outcomes after radical prostatectomy: challenges and misconceptions. J. Urol. 2009; 181: 462-471.
Sivarajan G, Prabhu V, Taksier GB, Laze J, Lepor H. Ten-year outcomes of sexual function after radical prostatectomy: results of a prospective longitudinal study. Eur Urol. 2014; 65: 58-65.
Araujo AB, Travison TG, Ganz P, Chiu GR, Kupelian V, Rosen RC, et al. Erectile dysfunction and mortality. J Sex Med 2009; 6: 2445-2454.
Du K, Zhang C, Presson AP, Tward JD, Brant WO, Dechet CB. Orgasmic function after radical prostatectomy. J. Urol. 2017; 198: 407-413.
Wittmann D, Carolan M, Given B, Skolarus TA, Crossley H, An L, et al. What couples say about their recovery of sexual intimacy after prostatectomy: toward the development of a conceptual model of couples’ sexual recovery after surgery for prostate cancer. J Sex Med 2015; 12(2): 494-504.
Simon Rosser BR, Capistrant B, Torres B, Konety B, Merengwa E, Mitteldorf D, et al. The effects of radical prostatectomy on gay and bisexual men’s mental health, sexual identity and relationships: qualitative results from the restore study. Sexual and Relationship Therapy 2015; 31(4): 446-461.
Simon JA, Pollycove R. Mercy sex: how much is “normal”. J Sex Med 2018; 15: S93.
Safilios-Rothschild C. A macro-and micro-examination of family power and love: An exchange model. J Marr & Family 1976; 38(2): 355-362.
Bagarozzi DA, Wodarski JS. A social exchange typology of conjugal relationships and conflict development. J Mar & Fam Ther 1977; 3(4): 53-60.
Perugia G, Liberti M, Vicini P, Colistro F, Gentile V. Use of local hyperthermia as prophylaxis of fibrosis and modification in penile length following radical retropubic prostatectomy. Int J Hypothermia 2005; 21(4): 359-365.
O’Leary MP. Erectile dysfunction. Boston, MA: Harvard Medical School.
Stephan E. Hypnotherapy for pain management, self esteem, and re-establishing sexuality & intimacy after surgery. Australian J Clin Hypother & Hypnosis 2014; 36(1): 47-60.
Bannowsky A, Schulze H, van der Horst C, Seif C, Braun PM, Junemann K-P. Nocturnal tumescence: a parameter for postoperative erectile integrity after nerve sparing radical prostatectomy. J. Urol. 2006; 175: 2214-2217.
Zippe CD, Kedia AW, Kedia K, Nelson DR, Agarwal A. Treatment of erectile dysfunction after radical prostatectomy with sildenafil citrate (Viagra). Urology 1998; 52: 963-966.
Raina R, Agarwal A, Ausmundson S, Lakin M, Nandipati KC, Montague DK, et al. Early use of vacuum constriction device following radical prostatectomy facilitates early sexual activity and potentially earlier return of erectile function. Int J Impotence Res 2006; 18: 77-81.
Vale J. Erectile dysfunction following radical therapy for prostate cancer. Radiotherapy & Oncology 57: 301-305.
Kalyvianakis D, Hatzichristou D. Low-intensity shockwave therapy improves hemodynamic parameters in patients with vasculogenic erectile dysfunction: a triplex ultrasonography-based sham-controlled study. J Sex Med 2017; 14: 891-897.
Fode M, Frey A, Jakobsen H, Sonksen J. Erectile function after radical prostatectomy – do patients return to baseline? J Urology 2015; 193 (4S): e774.
Goldstein I, Mulhall JP, Bushmakin AG, Cappelleri JC, Hvidsten K, Symonds T. The Erection Hardness Score and its relationship to successful sexual intercourse. J Sex Med 2008; 5: 2374-2380.
Hassouna MM, Heaton JPW. Prostate cancer: 8. Urinary incontinence and erectile dysfunction. CMAJ 1999; 160: 78-86.
Constabile RA. Optimizing treatment for diabetes mellitus induced erectile dysfunction. J Urol. 2003; 170: S35-S39.
Hartman ME, Irvine J, Currie KL, Ritvo P, Trachtenberg L, Louis A, et al. Exploring gay couples’ experience with sexual dysfunction after radical prostatectomy: a qualitative study. J Sex & Marital Therapy 40(3): 233-253.
Ussher, JM, Perz J, Kellett A, Chambers S, Latini D, Davis ID, et al. Health-related quality of life, psychological distress, and sexual changes following prostate cancer: A comparison study of gay and bisexual men with heterosexual men. J Sex Med. 2016; 13: 425-434.
DOI: http://dx.doi.org/10.18103/imr.v6i3.851
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