oru.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Dyadic aspects of sexual well-being and penile carcinoma: a prospective study
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Introduction. Coping with a diagnosis of cancer and, its treatment and recovery is a dyadic process within a relationship. Sexual dysfunctions and problems of penile cancer may add to the demands of coping. There are clinical reasons to view a couple’s sexuality, alone and together, as dependent factors for successful treatment.

Aim. The prospective study aimed to describe the dyadic aspects of sexual well-being and life satisfaction before and one year after organ-sparing laser treatment of penile carcinoma.

Methods. A consecutive series of 29 patients with penile carcinoma suitable for laser treatment were included together with their partners; median age was 60 (37-73) years and 57 (30-72) years, respectively. Length of partner relationship ranged between 1 and 54 years; median 29 years. The participants completed structured interviews before treatment, and at 6 months’ and 12 months’ follow-up. The interview addressed sexual activities, sexual functions, verbal (sexual) communication skills, and life satisfaction.

Main outcome measures. The interviews contained almost the same questions for patients and partners at all three measuring points. Moreover, three well-validated instruments were included: HADS, IIEF-5, and LiSat-11. Most of the questions were extracted from a national representative study of Swedish men and women and from this sample an ad hoc comparator population of 935 men and 809 women was selected.

Results. There were no significant differences between interview data at 6 and 12 months’ follow-up. Eight out of 29 couples had not been sexually active for several years before diagnosis and did not resume activity; further 4 couples had ceased having penetrative intercourse at follow-up. Sexual dysfunctions were common among men, especially decreased sexual interest and dyspareunia and about a fourth of the women had decreased vaginal lubrication before treatment. At follow-up increased sexual function was found, with the exception of erectile function and partners’ orgasm. The couples showed within-couple agreement concerning sexual activities, erectile dysfunction, retarded ejaculation, and lubrication dysfunction. Relatively few (41%) had an ongoing verbal mutual communication about their sexuality. Overall life satisfaction was found to be at par with the general population as most of domains of closeness, health, leisure and provision. Exceptions were patients somatic health and, at follow-up, sexual satisfaction. Couples with an active partner-related sexual life at follow-up showed coherence in high satisfaction with life as a whole. Sexually inactive couples showed coherence in being dissatisfied with their sexual life at baseline as well as after 12 months.

Keywords [en]
penile carcinoma; laser treatment; prospective; organ-sparing; sexual function; sexual dysfunction; sexual satisfaction; life satisfaction
National Category
Surgery
Research subject
Surgery esp. Urology Specific
Identifiers
URN: urn:nbn:se:oru:diva-26544OAI: oai:DiVA.org:oru-26544DiVA, id: diva2:572939
Available from: 2012-11-29 Created: 2012-11-29 Last updated: 2017-10-17Bibliographically approved
In thesis
1. Penile carcinoma: from first symptom to sexual function and life satisfaction following organ-sparing laser treatment
Open this publication in new window or tab >>Penile carcinoma: from first symptom to sexual function and life satisfaction following organ-sparing laser treatment
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to describe how patients with penile carcinoma experienced their symptoms, treatment seeking and the impact of the diagnosis and treatment on sexual function, sexual activity and life satisfaction. The thesis contains two studies of patients treated with organ-sparing laser therapy, a retrospective study (Papers II and III) of 46 patients treated between 1986-2000 and a prospective study (Papers I and IV) of 50 patients between 2005 and 2009 and additional 34 partners. In both studies face-to-face interviews were used with a structured questionnaire; and self-assessment instruments IIEF-5, LiSat-11, and HADS. An ad hoc comparator population of men aged 34–74 years from a nationally representative investigation of sexual life and life satisfaction in Swedes was chosen for some of the questions concerning sexuality and life satisfaction. We found a delay of more than 6 months in 37% of the patients in the retrospective study and 65% of the patients in the prospective study. The single most important reason for patients’ delay was embarrassment. Nine patients had a doctors’ delay of more than 3 months from first special visit until diagnosis. Eight of these patients consulted dermatologists and were subjected to repeated biopsies, leaving premalignant results (I, II). All patients younger than 75 years (34/46) in the retrospective study reported that they were sexual active before treatment, 80% of these had resumed their activity by the time of the interview. Furthermore, except for satisfaction with somatic health, similar—or even higher—proportions of patients than comparators were satisfied with life as a whole and with other domains of life including satisfaction with sexual life (III). We found that 21/29 couples were sexually active with intercourse before treatment and 17 couples resumed their activity. Two items differed markedly from the comparators; considerably fewer patients were satisfied with their somatic health, and satisfaction with sexual life (at 12 months follow-up). Couples with an active partner-related sexuality at 12 months follow-up, reported coherence in high satisfaction with life as a whole (IV).In conclusion, patients with penile carcinoma delay for a long time after identifying symptoms before seeking contact with the health care system. This delay is mainly caused by embarrassment in describing the symptom to health care personnel and deficient knowledge about the disease. Organ- sparing technique offers good, satisfying cosmetic results and the possibility of maintaining sexual activity and function to a great extent.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2012. p. 101
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 73
Keywords
Penile carcinoma, sexuality, life satisfaction, treatment-seeking, sexual function, Sexual dysfunction, delay, organ-sparing
National Category
Medical and Health Sciences Cancer and Oncology Urology and Nephrology
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-24417 (URN)978-91-7668-891-5 (ISBN)
Public defence
2012-10-19, Wilandersalen, Universitetssjukhuset, Örebro, 13:00 (Swedish)
Opponent
Supervisors
Note

Varierande stavning av förnamnet Elisabet förekommer.

Available from: 2012-08-24 Created: 2012-08-15 Last updated: 2017-10-17Bibliographically approved

Open Access in DiVA

No full text in DiVA

Authority records BETA

Skeppner, Elisabet

Search in DiVA

By author/editor
Skeppner, Elisabet
By organisation
School of Health and Medical Sciences, Örebro University, Sweden
Surgery

Search outside of DiVA

GoogleGoogle Scholar

urn-nbn

Altmetric score

urn-nbn
Total: 103 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf