[Sexuality and prostate cancer]

Abstract

Introduction: All treatments for prostate cancer have a negative impact on sexuality. The objective of this review is to highlight recent developments in the management of sexual dysfunction associated with prostate cancer.

Material and methods: We performed a literature search in the Pubmed database to select relevant articles.

Results: There is a specific profile of changes in the fields of sexual, urinary, bowel and general quality of life, according to the treatment modalities chosen. Maintenance of a satisfying sex life is a major concern of a majority of men facing prostate cancer and its treatments. It is essential to assess the couple's sexuality before treating prostate cancer in order to deliver comprehensive information and consider early therapeutic solutions adapted to the couple's expectations. The results of randomized studies show that robotic radical prostatectomy allows a faster recovery of natural erections compared to classic laparoscopy. Active pharmacological erectile rehabilitation (intracavernous injections or phosphodiesterase type 5 inhibitors [PDE5i] on demand, during the month following surgery) or passive (daily PDE5i after surgery) might improve the quality of erections especially in response to PDE5i. Unimpaired aspects of sexual response (orgasm) may, when the erection is not yet recovered, represent an alternative allowing the couple to preserve intimacy and complicity. Androgen blockade is a major barrier to maintain or return to a satisfying sex.

Conclusion: After the treatment of prostate cancer, one specific support sometimes assisted by networking will optimize satisfying sex life recovery.

Keywords: Cancer; Couple; Prostate; Prostate cancer; Prostatectomie totale; Radical prostatectomy; Rehabilitation; Rééducation; Sexuality; Sexualité.