Session: MP61: Prostate Cancer: Localized: Surgical Therapy II
MP61-05: Prevalence of Orgasmic Dysfunction after Robot-Assisted Radical Prostatectomy and Its Relevance to the International Index of Erectile Function
Department of Urology, Tottori University Faculty of Medicine
Introduction: The cause of orgasmic dysfunction is not well understood, and how many and which patients undergoing radical prostatectomy, especially robot-assisted radical prostatectomy (RARP), are affected remains unclear. Moreover, relationship between post-RARP orgasmic dysfunction and erectile dysfunction has not been clarified. This study aimed to evaluate the incidence of orgasmic dysfunction in patients after RARP and identify the relevance of orgasmic dysfunction to the International Index of Erectile Function (IIEF). Methods: We performed a single-center, cross-sectional, questionnaire-based investigation of patients who underwent RARP (n = 523). Of the 523 patients, men who received neoadjuvant therapy (n = 54), adjuvant therapy (n = 46), or died from other causes (n = 6) were excluded, leaving 417 patients for analysis. All patients were treated at our institution between 3 and 111 months prior to the start of the study. Six questions on sexual activity, orgasmic function, altered perception of orgasms, dysorgasmia, and climacturia were developed. Questionnaires about orgasmic dysfunction and IIEF were mailed with a letter inviting patients to participate in the study. The primary outcome measure was the prevalence of orgasmic dysfunction. The relationship between orgasmic dysfunction and IIEF domain scores was analyzed. Results: Overall, 259 questionnaires were available for analyses. Among sexually active patients (n = 145), 33 (22.8%) reported anorgasmia, 22 (15.1%) reported dysorgasmia, and 44 (30.3%) reported climacturia. The IIEF-erectile function (EF), IIEF-sexual desire (SD), IIEF-intercourse satisfaction (IS), and IIEF-overall satisfaction (OS) scores of the anorgasmia group were significantly lower than those of the non-anorgasmia group (2.33 ± 1.63 versus 7.93 ± 7.94, p <0.001; 3.91 ± 2.05 versus 5.13 ± 1.73, p <0.001; 0.39 ± 1.09 versus 1.92 ± 3.44, p = 0.013; 3.73 ± 1.59 versus 5.38 ± 1.78, p <0.001). Also, the IIEF-EF, IIEF-SD, and IIEF-OS scores of the dysorgasmia group were significantly lower than those of the non-dysorgasmia group (4.36 ± 4.86 versus 8.81 ± 8.32, p = 0.018; 4.32 ± 1.73 versus 5.32 ± 1.68, p = 0.014; 4.46 ± 1.65 versus 5.60 ± 1.75, p = 0.006). Conclusions: Orgasmic dysfunction is a common adverse effect of RARP. Moreover, these results indicate that anorgasmia and dysorgasmia may be associated with erectile function and may affect sexual desire and satisfaction after RARP. SOURCE OF Funding: None
