Ability to Reach Orgasm in Patients With Prostate Cancer Treated With Robot-assisted Laparoscopic Prostatectomy.

OBJECTIVES: To study the ability to reach orgasm after robot-assisted laparoscopic prostatectomy (RALP) in relation to demographic, cancer-related, and surgical variables, and the use of erectile aids. METHODS: In this cross-sectional study at a mean of 3 years after RALP at Oslo University Hospital, 982 men were invited to complete a mailed questionnaire, and 777 responded. Respondents who reported postoperative radiotherapy or hormone treatment, or did not report on orgasm were omitted, leaving 609 patients for analysis. Ability to reach orgasm was rated on 1 question from The Expanded Prostate Cancer Index Composite 26-item version, and dichotomized into "good" or "poor." RESULTS: Overall, 27% of the men reported good ability to reach orgasm: 22% among those did not use erectile aids and 34% among those did (P = .001). Univariate analysis of men with good versus poor ability to reach orgasm showed many significant differences. In multivariate analysis, being older, having a reduced physical quality of life, and erectile dysfunction were significantly associated with poor ability to reach orgasm. Erectile dysfunction showed an odds ratio of 4.86 for poor orgasmic ability. The 48% of men who used erectile aids had significantly better orgasmic ability than the nonusers. CONCLUSION: In our sample, 27% had good ability to reach orgasm at a mean of 3 years after RALP. Poor orgasmic ability was associated with being older, poor erectile function, and a reduced physical quality of life. Using erectile aids increased the rate of good ability to reach orgasm.

Aspects of posttraumatic stress disorder in long-term testicular cancer survivors: cross-sectional and longitudinal findings.

PURPOSE: The purpose of this research is to study the prevalence of posttraumatic stress disorder (PTSD) and variables associated with PTSD in Norwegian long-term testicular cancer survivors (TCSs) both cross-sectionally and longitudinally. METHODS: At a mean of 11 years after diagnosis, 1418 TCSs responded to a mailed questionnaire, and at a mean of 19 years after diagnosis, 1046 of them responded again to a modified questionnaire. Posttraumatic symptoms related to testicular cancer were self-rated with the Impact of Event Scale (IES) at the 11-year study only. An IES total score ≥35 defined Full PTSD, and a score 26-34 identified Partial PTSD, and the combination of Full and Partial PTSD defined Probable PTSD. RESULTS: At the 11-year study, 4.5 % had Full PTSD, 6.4 % had Partial PTSD, and 10.9 % Probable had PTSD. At both studies, socio-demographic variables, somatic health, anxiety/depression, chronic fatigue, and neurotoxic adverse effects were significantly associated with Probable PTSD in bivariate analyses. Probable anxiety disorder, poor self-rated health, and neurotoxicity remained significant with Probable PTSD in multivariate analyses at the 11-year study. In bivariate analyses, probable PTSD at that time significantly predicted socio-demographic variables, somatic health, anxiety/depression, chronic fatigue, and neurotoxicity among participants of the 19-year study, but only probable anxiety disorder remained significant in multivariable analysis. CONCLUSIONS: In spite of excellent prognosis, 10.9 % of long-term testicular cancer survivors had Probable PTSD at a mean of 11 years after diagnosis. Probable PTSD was significantly associated with a broad range of problems both at that time and was predictive of considerable problems at a mean of 19 year postdiagnosis. IMPLICATIONS FOR CANCER SURVIVORS: Among long-term testicular cancer survivors, 10.9 % have Probable PTSD with many associated problems, and therefore health personnel should explore stress symptoms at follow-up since efficient treatments are available.

A comparative study of erectile function and use of erectile aids in high-risk prostate cancer patients after robot-assisted laparoscopic prostatectomy.

OBJECTIVE: Erectile function with and without use of erectile aids was compared in high-, intermediate- and low-risk prostate cancer patients at a mean of 3 years after robot-assisted laparoscopic prostatectomy (RALP). MATERIALS AND METHODS: A sample of 982 men who underwent RALP at Oslo University Hospital, Radiumhospitalet, between 2005 and 2010 was invited to complete a mailed questionnaire in 2011. The response rate was 79%, but only 609 patients did not have adjuvant treatment and reported on erection. The sample consisted of 29% high-risk, 40% intermediate-risk and 25% low-risk patients according to the preoperative D'Amico classification. Based on questionnaire data, two primary outcomes were defined: ability to have intercourse (sufficient erection), and use and effect of erectile aids. RESULTS: Sufficient erection with or without erectile aids was reported by 19% of the high-, 30% of the intermediate- and 19% of the low-risk group (not significant). Erectile aids were used by 48% of the sample, of whom 18% of the high-, 21% of the intermediate- and 14% of the low-risk group reported sufficient erection (not significant). Papaverine injections were used by 21% and phosphodiesterase-5 inhibitors by 28% of the sample. Limitations were the lack of data on erection baseline and on penile rehabilitation. CONCLUSIONS: Nearly half of the sample used erectile aids, which significantly increased the proportion with sufficient erection in all risk groups after RALP. With and without the use of erectile aids, the proportions of patients with sufficient erection were 30% or less, with non-significant differences between groups.