Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Perspective
  • Published:

Sexual aspects of shared decision making and prehabilitation in men diagnosed with prostate cancer

Abstract

This article addresses sexual aspects of two related HCP-roles in the period between a diagnosis of prostate cancer (PC) and the start of treatment. First, the ‘lovemap-perspective’ is used to fine-tune the process of shared decision making. Then sexual prehabilitation is explored in detail, in the belief that better sexual function before starting treatment is more likely to lead to better post-treatment outcomes. Recommendations will be shared on further development of sexual prehabilitation approaches.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Frey A, Pedersen C, Lindberg H, Bisbjerg R, Sønksen J, Fode M. Prevalence and predicting factors for commonly neglected sexual side effects to external-beam radiation therapy for prostate cancer. J Sex Med. 2017;14:558–65.

    Article  Google Scholar 

  2. Sullivan JF, Stember DS, Deveci S, Akin-Olugbade Y, Mulhall JP. Ejaculation profiles of men following radiation therapy for prostate cancer. J Sex Med. 2013;10:1410–6.

    Article  Google Scholar 

  3. Fode M, Serefoglu EC, Albersen M, Sønksen J. Sexuality following radical prostatectomy: is restoration of erectile function enough? Sex Med Rev. 2017;5:110–9.

    Article  Google Scholar 

  4. EMIS. First report. 2013. http://www.emis-project.eu/sites/default/files/public/publications/emis-2010_european_msm_internet_survey_38_countries_v5.pdf.

  5. Joh DY, Chen LN, Porter G, Bhagat A, Sood S, Kim JS, et al. Proctitis following stereotactic body radiation therapy for prostate cancer. Radiat Oncol. 2014;9:277.

    Article  Google Scholar 

  6. Krol R, Smeenk RJ, van Lin EN, Yeoh EE, Hopman WP. Systematic review: anal and rectal changes after radiotherapy for prostate cancer. Int J Colorectal Dis. 2014;29:273–83.

    Article  Google Scholar 

  7. Nasser NJ, Cohen GN, Dauer LT, Zelefsky MJ. Radiation safety of receptive anal intercourse with prostate cancer patients treated with low-dose-rate brachytherapy. Brachytherapy. 2016;15:420–5.

    Article  Google Scholar 

  8. Levin RJ. Prostate-induced orgasms: a concise review illustrated with a highly relevant case study. Clin Anat. 2018;31:81–5.

    Article  CAS  Google Scholar 

  9. Finney G, Haynes AM, Cross P, Brenner P, Boyn A, Stricker P. Cross-sectional analysis of sexual function after prostate brachytherapy. Urology. 2005;66:377–81.

    Article  Google Scholar 

  10. Hess KL, DiNenno E, Sionean C, Ivy W, Paz-Bailey G, NHBS Study Group. Prevalence and correlates of heterosexual anal intercourse among men and women, 20 US cities. AIDS Behav. 2016;20:2966–75.

    Article  Google Scholar 

  11. Mulhall JP. Saving your sex life. A guide for men with prostate cancer. Potomac: C-I-Act; 2010.

  12. Silver JK, Baima J. Cancer prehabilitation: an opportunity to decrease treatment-related morbidity, increase cancer treatment options, and improve physical and psychological health outcomes. Am J Phys Med Rehabil. 2013;92:715–27.

    Article  Google Scholar 

  13. MacDonald R, Fink HA, Huckabay C, Monga M, Wilt TJ. Pelvic floor muscle training to improve urinary incontinence after radical prostatectomy: a systematic review of effectiveness. BJU Int. 2007;100:76–81.

    Article  Google Scholar 

  14. Milios JE, Ackland TR, Green DJ. Pelvic floor muscle training in radical prostatectomy: a randomized controlled trial of the impacts on pelvic floor muscle function and urinary incontinence. BMC Urol. 2019;19:116.

    Article  Google Scholar 

  15. Tsimopoulou I, Pasquali S, Howard R, Desai A, Gourevitch D, Tolosa I, et al. Psychological prehabilitation before cancer surgery: a systematic review. Ann Surg Oncol. 2015;22:4117–23.

    Article  Google Scholar 

  16. Cohen L, Parker PA, Vence L, Savary C, Kentor D, Pettaway C, et al. Presurgical stress management improves postoperative immune function in men with prostate cancer undergoing radical prostatectomy. Psychosom Med. 2011;73:218–25.

    Article  Google Scholar 

  17. Alemozaffar M, Regan MM, Cooperberg MR, Wei JT, Michalski JM, Sandler HM, et al. Prediction of erectile function following treatment for prostate cancer. JAMA. 2011;306:1205–14.

    Article  CAS  Google Scholar 

  18. Kirby MG, White ID, Butcher J, Challacombe B, Coe J, Grover L, et al. Development of UK recommendations on treatment for post-surgical erectile dysfunction. Int J Clin Pr. 2014;68:590–608.

    Article  CAS  Google Scholar 

  19. Osadchiy V, Eleswarapu SV, Mills SA, Pollard ME, Reiter RE, Mills JN. Efficacy of a preprostatectomy multi-modal penile rehabilitation regimen on recovery of postoperative erectile function. Int J Impot Res. 2020;32:323–8.

    Article  CAS  Google Scholar 

  20. Paterson C, Primeau C, Pullar I, Nabi G. Development of a prehabilitation multimodal supportive care interventions for men and their partners before radical prostatectomy for localized prostate cancer. Cancer Nurs. 2019;42:E47–53.

    Article  Google Scholar 

  21. Ussher JM, Perz J, Gilbert E, Wong WK, Hobbs K. Renegotiating sex and intimacy after cancer: resisting the coital imperative. Cancer Nurs. 2013;36:454–62.

    Article  Google Scholar 

  22. Kukula KC, Jackowich RA, Wassersug RJ. Eroticization as a factor influencing erectile dysfunction treatment effectiveness. Int J Impot Res. 2014;26:1–6.

    Article  CAS  Google Scholar 

  23. Kleinplatz PJ, Charest M, Paradis N, Ellis M, Rosen L, Ménard AD, et al. Treatment of low sexual desire or frequency using a sexual enhancement group couples therapy approach. J Sex Med. 2020;17:1288–96.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Woet L. Gianotten.

Ethics declarations

Conflict of interest

The author declares that he has no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gianotten, W.L. Sexual aspects of shared decision making and prehabilitation in men diagnosed with prostate cancer. Int J Impot Res 33, 397–400 (2021). https://doi.org/10.1038/s41443-020-00404-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41443-020-00404-5

Search

Quick links