Sexual function after radical cystectomy in males with bladder carcinoma: a six-year longitudinal single-centre study
IntroductionLittle is known about the long-term effects on sexual function (SF) after radical cystectomy (RC) in bladder carcinoma (BC) patients.AimTo assess the course of SF in BC patients who underwent RC, and individual characteristics that influence the sexual outcome during a six-year follow-up...
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Urology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fruro.2023.1100516/full |
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| author | Claudia E. Pronk Leonore F. Albers Lothar D. J. Kuijper Kees Hendricksen Melianthe P. J. Nicolai |
| author_facet | Claudia E. Pronk Leonore F. Albers Lothar D. J. Kuijper Kees Hendricksen Melianthe P. J. Nicolai |
| author_sort | Claudia E. Pronk |
| collection | DOAJ |
| description | IntroductionLittle is known about the long-term effects on sexual function (SF) after radical cystectomy (RC) in bladder carcinoma (BC) patients.AimTo assess the course of SF in BC patients who underwent RC, and individual characteristics that influence the sexual outcome during a six-year follow-up.MethodsIn this longitudinal study, 62 BC patients treated with RC were included between 2008 and 2022. Patients filled out validated questionnaires as part of the regular care at baseline, three months, six months, 12 months and thereafter yearly post RC.Outcome measuresTo determine the sexual function, the International Index of Erectile Function questionnaire was filled in and a linear mixed model for repeated measures was conducted. The analysed clinical variables included sexual preserving cystectomy (SPC), age, type of diversion, treatment, comorbidities, tumour status, smoking habits, patient status and open- or robot-assisted RC. A Generalised Linear Mixed Model was used to evaluate the impact on Quality of Life with the QLQ-C30 questionnaire.ResultsAfter an initial decrease of sexual function post-RC, no change in SF was seen during the six years of follow-up. A statistically significant difference in sexual health was found between SPC and standard RC (p=0.015), which was time-dependent. Patients with an orthotopic ileal neobladder experienced a significantly better SF than those with a Bricker’s ileal conduit (p=<0.001). A younger age also seemed to yield beneficial outcomes regarding SF (p=0.004). Other analysed clinical variables did not influence the course of SF. A statistically significant positive correlation was found between Quality of Life- and SF scores (p=0.004). Robot-assisted RC resulted in higher Global Health scores than open RC (p=0.001).ConclusionsRC has a severe impact on sexual function. Although SPC, collinear with the use of an orthotopic ileal neobladder and younger patient age show better outcomes in SF, erectile dysfunction post-RC is moderate to severe in the vast majority of patients. |
| first_indexed | 2024-03-11T20:19:47Z |
| format | Article |
| id | doaj.art-c725d568824a4c93a03d30fa3614baae |
| institution | Directory Open Access Journal |
| issn | 2673-9828 |
| language | English |
| last_indexed | 2024-03-11T20:19:47Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Urology |
| spelling | doaj.art-c725d568824a4c93a03d30fa3614baae2023-10-03T08:51:50ZengFrontiers Media S.A.Frontiers in Urology2673-98282023-10-01310.3389/fruro.2023.11005161100516Sexual function after radical cystectomy in males with bladder carcinoma: a six-year longitudinal single-centre studyClaudia E. Pronk0Leonore F. Albers1Lothar D. J. Kuijper2Kees Hendricksen3Melianthe P. J. Nicolai4Urology Department, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, NetherlandsDepartment of Urology, Leiden University Medical Centre, Leiden, The Netherlands; Department of Urology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, NetherlandsDepartment of Health Science, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsUrology Department, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, NetherlandsUrology Department, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, NetherlandsIntroductionLittle is known about the long-term effects on sexual function (SF) after radical cystectomy (RC) in bladder carcinoma (BC) patients.AimTo assess the course of SF in BC patients who underwent RC, and individual characteristics that influence the sexual outcome during a six-year follow-up.MethodsIn this longitudinal study, 62 BC patients treated with RC were included between 2008 and 2022. Patients filled out validated questionnaires as part of the regular care at baseline, three months, six months, 12 months and thereafter yearly post RC.Outcome measuresTo determine the sexual function, the International Index of Erectile Function questionnaire was filled in and a linear mixed model for repeated measures was conducted. The analysed clinical variables included sexual preserving cystectomy (SPC), age, type of diversion, treatment, comorbidities, tumour status, smoking habits, patient status and open- or robot-assisted RC. A Generalised Linear Mixed Model was used to evaluate the impact on Quality of Life with the QLQ-C30 questionnaire.ResultsAfter an initial decrease of sexual function post-RC, no change in SF was seen during the six years of follow-up. A statistically significant difference in sexual health was found between SPC and standard RC (p=0.015), which was time-dependent. Patients with an orthotopic ileal neobladder experienced a significantly better SF than those with a Bricker’s ileal conduit (p=<0.001). A younger age also seemed to yield beneficial outcomes regarding SF (p=0.004). Other analysed clinical variables did not influence the course of SF. A statistically significant positive correlation was found between Quality of Life- and SF scores (p=0.004). Robot-assisted RC resulted in higher Global Health scores than open RC (p=0.001).ConclusionsRC has a severe impact on sexual function. Although SPC, collinear with the use of an orthotopic ileal neobladder and younger patient age show better outcomes in SF, erectile dysfunction post-RC is moderate to severe in the vast majority of patients.https://www.frontiersin.org/articles/10.3389/fruro.2023.1100516/fullbladder cancersexual functionradical cystectomymaleerectile function |
| spellingShingle | Claudia E. Pronk Leonore F. Albers Lothar D. J. Kuijper Kees Hendricksen Melianthe P. J. Nicolai Sexual function after radical cystectomy in males with bladder carcinoma: a six-year longitudinal single-centre study Frontiers in Urology bladder cancer sexual function radical cystectomy male erectile function |
| title | Sexual function after radical cystectomy in males with bladder carcinoma: a six-year longitudinal single-centre study |
| title_full | Sexual function after radical cystectomy in males with bladder carcinoma: a six-year longitudinal single-centre study |
| title_fullStr | Sexual function after radical cystectomy in males with bladder carcinoma: a six-year longitudinal single-centre study |
| title_full_unstemmed | Sexual function after radical cystectomy in males with bladder carcinoma: a six-year longitudinal single-centre study |
| title_short | Sexual function after radical cystectomy in males with bladder carcinoma: a six-year longitudinal single-centre study |
| title_sort | sexual function after radical cystectomy in males with bladder carcinoma a six year longitudinal single centre study |
| topic | bladder cancer sexual function radical cystectomy male erectile function |
| url | https://www.frontiersin.org/articles/10.3389/fruro.2023.1100516/full |
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