Defining sexual outcomes after treatment for XXXX .

@entity1 @entity323 @entity263 @entity458
BACKGROUND: The objective of this survey was to identify factors associated with good sexual outcomes in a large group of survivors of @entity263 . METHODS: A postal survey was sent to 2636 @entity1 in the Cleveland Clinic Foundation's @entity263 Registry who either were treated with definitive radiotherapy or underwent prostatectomy for @entity263 . The survey asked about demographic items, past and current sexual functioning, partner's sexual function and health, and a number of factors hypothesized to affect sexual satisfaction. Standardized questionnaires included the Sexual Self-Schema Scale-Male Version, the International Index of Erectile Function (IIEF), urinary and bowel symptom scales from the Los Angeles @entity263 Index, and the Short Form Health Survey (SF-36). RESULTS: The return rate was 49%, yielding a sample of 1236 @entity1 at an average of 4.3 years post-treatment. Comparing responders with nonresponders suggested that the sample may have been somewhat biased toward @entity1 who were more interested in maintaining sexual function. At the time they were diagnosed with @entity263 , 36% of @entity1 had @entity323 ( @entity323 ). Within the past 6 months, however, 85% of @entity1 reported having @entity323 . Only 13% of @entity1 were having reliable, firm erections spontaneously, and another 8% of @entity1 were having erections with the aid of a medical treatment. @entity1 were as distressed about @entity458 and trouble having satisfying orgasms as they were about @entity323 . Of the 84% of @entity1 who reported having a current sexual partner, 66% indicated that she had a @entity458 . Younger age was associated strongly with better sexual outcome (global IIEF score). With demographic factors taken into account, better sexual outcome was related significantly to medical factors, including not having neoadjuvant or current antiandrogen therapy, undergoing bilateral nerve-sparing prostatectomy or brachytherapy, and having better mental and physical health composite scores on the SF-36. Sexual factors that were associated with a better outcome included having normal erections before treatment for @entity263 , choosing a treatment based on the hope that it would preserve sexual function, having more sexual partners in the past year, and having a sexually functional partner. CONCLUSIONS: The great majority of @entity1 who survive @entity263 do not achieve a return to functional sexual activity in the years after treatment. The priorities a @entity1 places on sexuality and on having a sexually functional partner are important factors in sexual satisfaction at follow-up, over and above the influence of age and medical factors.
