Five-year outcomes from a randomised controlled trial of a couples-based intervention for men with localised prostate cancer.

OBJECTIVE: Psychosexual morbidity is common after prostate cancer treatment, however, long-term prospective research is limited. We report 5-year outcomes from a couples-based intervention in dyads with men treated for localised prostate cancer with surgery. METHODS: A randomised controlled trial was conducted involving 189 heterosexual couples, where the man received a radical prostatectomy for prostate cancer. The trial groups were peer support vs. nurse counselling versus usual care. Primary outcomes were sexual adjustment, unmet sexual supportive care needs, masculine self-esteem, marital satisfaction, and utilisation of erectile aids at 2-, 3-, 4- and 5-year follow-up. RESULTS: The effects of the interventions varied across the primary outcomes. Partners in the peer group had higher sexual adjustment than those in the usual care and nurses group at 2 and 3 years (P = 0.002-0.035). Men in usual care had lower unmet sexual supportive care needs than men in the peer and nurse groups (P = 0.001; P = 0.01) at 3 years. Women in usual care had lower sexual supportive care needs than women in the peer group at 2 and 3 years (P = 0.038; P = 0.001). Men in the peer and nurse group utilised sexual aids more than men in usual care; at 5 years 54% of usual care men versus 87% of men in peer support and 80% of men in the nurse group. CONCLUSION: Peer and nurse-administered psychosexual interventions have potential for increasing men's adherence to treatments for erectile dysfunction. Optimal effects may be achieved through an integrated approach applying these modes of support.

A randomised controlled trial of a couples-based sexuality intervention for men with localised prostate cancer and their female partners.

OBJECTIVE: The diagnosis and treatment of prostate cancer is followed by substantive sexual morbidity. The optimal approach for intervening remains unclear. METHODS/DESIGN: A three-arm randomised control trial was undertaken with 189 heterosexual couples where the man had been diagnosed with prostate cancer and treated surgically. The efficacy of peer-delivered telephone support versus nurse-delivered telephone counselling versus usual care in improving both men's and women's sexual adjustment was investigated. Assessments were undertaken at baseline (pre-test) with follow-up at 3, 6 and 12 months. RESULTS: At 12 months, men in the peer (p = 0.016) and nurse intervention (p = 0.008) were more likely to use medical treatments for erectile dysfunction (ED) than men in the usual care arm. Men in the nurse intervention more frequently used oral medication for ED than men in usual care (p = 0.002). No significant effects were found for sexual function, sexuality needs, sexual self-confidence, masculine self-esteem, marital satisfaction or intimacy. CONCLUSION: Although peer and nurse couples-based interventions can increase use of medical treatments for ED, this may not translate into better sexual or relationship outcomes. More research is needed into the optimal timing of interventions to improve sexual outcomes for men with prostate cancer and to identify the subpopulations that will benefit from them.

Long-term psychosexual adjustment of adults born with classic bladder exstrophy.

BACKGROUND: In literature studies exploring long-term psychosexual development and intimacy of adults living with the complex genitourinary conditions associated with classic bladder exstrophy (BE) are scarce, with small sample sizes and lacking in methodology. OBJECTIVE: This study aims to examine areas of potential psychosexual distress in adults born with classic BE to develop targeted clinical interventions. STUDY DESIGN: The validated Sexrelation Evaluation Schedule Assessment Monitoring (SESAMO) questionnaire was administered to all BE patients aged ≥18 years operated on in our tertiary referral center during infancy. Z-scores were calculated for each area of interest, considering i) gender (female vs male); ii) committed partnership status (singles vs couples); iii) the voiding technique adopted to empty the bladder. RESULTS: A total of 33 (F:M 12:21; singles: couples 11:22) adults with BE were enrolled in the study at a median age of 39 (32-47) years. Overall, BE adults performed the worst regarding psychosexual identity (z-score:-1.282), pleasure (z-score:-0.915) and desire (z-score:-0.583); singles regarding relational attitude (z-score:-1.751) and imaginative eroticism (z-score:-0.806); couples regarding extramarital sexuality (z-score:-1.175) and sexual communication (z-score:-0.255). When it came to gender, females significantly performed worse than males regarding psychosexual identity (-1.645 vs -1.282; p-value:<0.0001) and areas of pleasure (-1.126 vs -0.359; p-value:<0.001). Single females performed worse than males regarding actual masturbation (-0.763 vs 0.583; p-value:<0.05) and better regarding relational attitude (-1.226 vs -1.751; p-value:<0.05). Females in stable relationships performed worse than males regarding actual masturbation (-1.645 vs 0.306; p-value:<0.05) and better regarding sexual intercourse (1.866 vs -0.565; p-value:<0.01). The voiding techniques used to empty the bladder did not show any influence on these results. CONCLUSION: Adults with BE have a greater likelihood of experiencing a wide range of psychosexual difficulties. Identifying the specific areas of psychological distress can help them cope with their medical experience and actual clinical condition and clinicians plan adequate psychological interventions.

Psychological and Psychosexual Adjustment in University Students as a Function of Sexual Activity and Relationship Type.

The objective of the present study was to examine the differences in some variables of psychological (depression, anxiety, physical self-esteem) and psychosexual (self-esteem as a sexual partner, satisfaction with sexual life, sexual preoccupation) adjustment in a sample of university students, as a function of gender, and divided into three groups: (1) those who had a stable partner; (2) those who did not have a stable partner but did have casual sexual relations; and (3) those who had neither a stable partner nor casual relationships. Participants were 980 students from a mid-size Spanish university, of both sexes (71.3% women, 28.7% men), aged between 18 and 26 years (M = 20.87, SD = 1.88), who completed an online battery of questionnaires. Differences were found in psychological and psychosexual adjustment variables depending on the reference group and both in men and women. Some of these differences were explained by having a partner and others by having sexual relations, regardless of the partner with whom they had sex. These differences and their impact on young people's psychological adjustment and wellness should be taken into account when designing sexual health prevention and promotion programs.

Leisure Satisfaction, Personality, and Psychosexual Adjustment Among College Students: A Latent Profile Analysis.

Although the factors influencing sexual health have been explored by researchers, the impact of leisure and personality on psychosexual adjustment and the interaction of these two factors remain unknown. This study investigated the relationship between leisure satisfaction and psychosexual adjustment based on the compensation theory and the social learning theory. The differences in psychosexual adjustment across different personality types were also explored. Finally, we examined the interaction between personality and leisure satisfaction based on the personal-environment fit models. The participants in this study were 1,161 college students. The results supported all the hypotheses proposed. There was a significant positive correlation between leisure satisfaction and psychosexual adjustment. Participants of four personality types (the overcontrolled, high-moderate, low-moderate, and resilient groups) had different performance in psychosexual adjustment. The resilient group had the highest scores, while the overcontrolled group had the lowest scores. The results suggest that there is an interaction between personality and leisure satisfaction. Our research could enrich the research contents of leisure and personality and provide a practical basis for the improvement of college students in psychosexual adjustment.