Does sexual rehabilitation work for gay and bisexual prostate cancer patients? Acceptability, feasibility, and efficacy results from the Restore-2 randomized controlled trial

B R Simon Rosser; Nidhi Kohli; Alex J Bates; Kristine M C Talley; Morgan M Wright; Elizabeth J Polter; Christopher W Wheldon; Ryan Haggart; Daniel R Dickstein; Michael W Ross; Ziwei Zhang; William West; Badrinath R Konety

doi:10.1007/s11764-024-01672-6

Does sexual rehabilitation work for gay and bisexual prostate cancer patients? Acceptability, feasibility, and efficacy results from the Restore-2 randomized controlled trial

J Cancer Surviv. 2024 Sep 12. doi: 10.1007/s11764-024-01672-6. Online ahead of print.

Authors

Affiliations

¹ Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., #300, Minneapolis, MN, 55454, USA. rosser@umn.edu.
² Department of Educational Psychology, University of Minnesota, 250 Education Sciences Bldg, 56 E River Rd, Minneapolis, MN, 55455, USA.
³ Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., #300, Minneapolis, MN, 55454, USA.
⁴ Adult and Gerontological Health, University of Minnesota School of Nursing School, 6-191 Weaver Densford Hall, 08 Harvard Street SE, Minneapolis, MN, 55455, USA.
⁵ Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1301 Cecil B. Moore Ave. Room 955, Philadelphia, PA, 19122, USA.
⁶ Department of Urology, University of Minnesota Medical School, Mayo Bldg, 420 Delaware St. Ste MMC 394, Minneapolis, MN, 55454, USA.
⁷ Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA.
⁸ Eli Coleman Institute for Sexual and Gender Health, Department of Family Medicine and Community Health,, University of Minnesota Medical School, 1300 S. 2nd St., Ste. 180, Minneapolis, MN, 55454, USA.
⁹ Department of Writing Studies, University of Minnesota, 213 Nolte Center, 315 Pillsbury Dr SE, Minneapolis, MN, 55455, USA.
¹⁰ Allina Health Cancer Institute, 800 E 28Th St, Minneapolis, MN, 55407, USA.

PMID: 39266938
DOI: 10.1007/s11764-024-01672-6

Abstract

Purpose: Sexual minority prostate cancer patients have worse health-related quality of life outcomes than heterosexual patients. We conducted the first study to test whether sexual and urinary rehabilitation tailored for sexual minority patients was acceptable, feasible, and efficacious at improving their sexual and urinary function.

Methods: Restore-2 was a 24-month randomized controlled trial of an online biopsychobehavioral rehabilitation study for sexual minority men treated for prostate cancer experiencing sexual and/or urinary problems. Participants were 401 US sexual minority men treated for prostate cancer and experiencing sexual and/or urinary problems at baseline. Intervention components included phosphodiesterase-5 inhibitors, sexual aids, a pelvic floor exercise regimen and video, a guide to good gay sex following treatment, and coaching. Quality of life assessments were completed at baseline, 3, 6, 12, 18, and 24 months.

Results: We confirmed good acceptability and feasibility, but only minimal improvement was observed over time and no differences were found between treatment and control arms.

Conclusions: We found no evidence that the intervention improved sexual or urinary outcomes for participants. However, we confirmed excellent acceptability and feasibility for a sexual rehabilitation program tailored to sexual minority participants. In addition, participants reported enduring usage and acceptability of sexual aids (including vacuum pump, anal dilators, and penile constriction rings) as well as masturbation and pelvic floor exercises to accommodate their sexual challenges.

Implications for cancer survivors: Sexual "accommodation," rather than "rehabilitation," may be a more accurate and realistic goal for this population. Patients should be provided sexual aids to help accommodate their sexual and urinary challenges.

Trial registration: This study was retrospectively registered with ClinicalTrials.gov, study number: NCT03923582; date: 22/04/2019.

Keywords: Health care disparity; Health status disparities; Prostatic neoplasms; Sexual dysfunction, Physiological; Sexual minorities.

Associated data

ClinicalTrials.gov/NCT03923582

Abstract

Associated data

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