Presentation Authors: Natasha Gupta*, Lauren Kucirka, Baltimore, MD, Alice Semerjian, Ypsilanti, MI, Trinity J. Bivalacqua, Baltimore, MD
Introduction: Radical cystectomy (RC) for bladder cancer can significantly affect the sexual health and function of both male and female patients. The goal of our study was to characterize provider practice regarding sexual health counseling of RC patients and whether practice differs between male and female patients.
Methods: We conducted a national survey of members of the Society of Urologic Oncology to assess topics included in pre- and post-operative sexual health counseling and identify barriers to counseling patients about sexual health. For each topic, we compared the frequency of counseling for male versus female patients using Chi-squared tests.
Results: A total of 136 of 723 members responded. Overall, the median age was 43 years (interquartile range [IQR] 38-51), 91.8% were male, 74.8% were in academic practice, 83.1% had completed a urologic oncology fellowship, and 86.2% trained residents. Average years in practice was 12.6Â±11.1, 99% had previously performed a female RC, and 31.4% had performed at least 10 female RC&[prime]s in the past year. Providers were significantly more likely to ask males if they were sexually active prior to RC compared to females (90.7% vs. 81.4%, respectively, p < 0.001) (Figure 1). Comparing preoperative counseling of sexually active male and female patients, providers were significantly more likely to ask male patients if they had baseline sexual dysfunction (79.6% vs. 38.4%, respectively, p=0.002), to discuss the risk of sexual dysfunction after RC with males (93.5% vs. 81.3%, respectively, p < 0.001), and to discuss the potential for nerve-sparing RC with males (70.4% vs. 31.3%, respectively, p=0.001); postoperatively, providers were significantly more likely to discuss sexual health and dysfunction issues with sexually active males versus sexually active females (80% vs. 56%, respectively, p < 0.001) (Figure 1). When asked about barriers to discussing sexual health with females, 67.4% listed older patient age, 58.7% said there was not enough time, and 46.7% listed uncertainty about patients&[prime] baseline sexual function.
Conclusions: There were significant disparities in the sexual health counseling that women received pre- and post-RC compared to men. Since RC has a significant impact on female sexual health, it is critical to address barriers to counseling women about these issues.
Source of Funding: The Greenberg Bladder Cancer Institute