Sexual inactivity following treatment for localized prostate: Prevalence, acceptance and patient-reported reasons

Abstract

Objectives

Sexual dysfunction is common after prostate cancer treatment. However, most of the focus has been on sexually active patients. The objective of this study was to examine the prevalence of sexual inactivity following treatment for localized prostate cancer and to explore the acceptance of this inactivity, and the patient-reported reasons behind it.

Methods

We pooled data from two questionnaire-based studies in men who had undergone either radical prostatectomy or low dose brachy therapy. The questionnaires inquired about sexually active, defined as engaging in any form of partnered sexual activity or in masturbation. Additionally, patients were questioned about their desire to be sexually active and posed an open-ended question about reasons for their sexual inactivity.

Results

The surveys were sent to 775 men and responses from 494 (63.7%) were available. 152 (30.8%) were not sexually active. The median age of the not sexually active men was 68 (range 54 – 81) years and 139 (91.4%) had a partner. 116 (76.3%) had undergone radical prostatectomy, while 36 (23.7%) had undergone brachy therapy. Overall, 114 (75.0%) had an unfulfilled desire to be sexually active. Of these, 95 shared the reasons for their inactivity including erectile dysfunction (84.2%), lack of libido (7.4%), lack of penile sensation (3.2%), lack of orgasm (1.1%), penile deviation (1.1%), urinary incontinence (1.1%), disease in spouse (1.1%), and fear of heart disease (1.1%). Of the 38 patients who did not desire to be sexually active, 24 reported reasons for their inactivity including erectile dysfunction (45.8%), lack of libido (45.8%), lack of penile sensation (4.2%), and a lack of desire in the partner (4.2%).

Conclusions

Many patients remained sexually inactive after prostate cancer treatment despite their desire for sexual activity. The primary reason was erectile dysfunction. This underscores the importance of patient education regarding alternative approaches to sexual intimacy.

Conflicts of Interest

The authors declare no conflict of interests
Original languageEnglish
Publication date8 Feb 2024
Publication statusPublished - 8 Feb 2024
EventEuropean Society for Sexual Medicine, Congress 2024 - Bari, Italy
Duration: 8 Feb 202410 Feb 2024
https://www.essm-congress.org/

Conference

ConferenceEuropean Society for Sexual Medicine, Congress 2024
Country/TerritoryItaly
CityBari
Period08/02/202410/02/2024
Internet address

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