Sexual function continues after radical cystectomy

Sexual interest and activity continued in patients with bladder cancer who received radical cystectomy, according to findings presented during the 2020 Society of Urologic Oncology Annual Meeting.¹

Despite significant illness, over half (53%) of patients surveyed reported at least a little interest in sexual activity. Further, the study met its primary outcome measure, with 40% of patients showing interest in sexual activity within 4 weeks of completing the survey.

For their study, the investigators assessed the sexual function of 150 patients undergoing radical cystectomy for bladder cancer. Patients were administered both The European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire–Bladder Cancer Muscle Invasive (EORTC QLQ–BLM 30) and Functional Assessment of Cancer Therapy–Bladder. Those who completed the sexual function subscale of the EORTC QLQ-BLM 30 (n = 132) were deemed eligible for the study.

The median age of all patients was 68.5 years, and 82% were male. The mean sexual function subscale score for all patients was 61.5 ± 25.2, with women having significantly worse mean scores of 72.9 ± 27.1 versus 59.1 ± 24.2 for men (P = .02)

On multivariate analysis, both age and female gender were independently associated with worse (higher) sexual function subscale scores.

When compared with women, men reported both higher rates of interest in sexual activity (57% vs 35%, respectively) and higher rates of sexual activity (43% vs 30%), with 33% of female responders admitting to feeling uncomfortable about being sexually intimate.

Investigators cited the lack of existing data regarding sexual function as the primary reason for conducting the study, noting that many urologists fail to discuss possible changes in sexual interest and function with patients prior to radical cystectomy. A lack of information regarding baseline sexual function was noted as a common barrier to initiating those conversations.

Noted limitations to the study were the relatively small sample size of female patients and an unknown meaningful clinical difference.

The authors stated that the results support a need for further investigation into the impact of surgery on sexual function, and that novel targeted interventions to improve outcomes may be needed.²

References

1. Westerman ME, Kokorovic A, Wang XS, et al. Radical cystectomy and perioperative sexual function: a cross-sectional analysis. Presented at: 21st Annual Meeting for the Society of Urologic Oncology; December 3, 2020. Poster 7.

2. Westerman ME, Kokorovic A, Wang XS, et al. Radical cystectomy and perioperative sexual function: A cross-sectional analysis. J Sex Med. 2020;17:1995–2004. doi:10.1016/j.jsxm.2020.06.015