Underestimation of ED risks of surgery by men undergoing prostrate surgery

According to a new study, men with sexual dysfunction post prostate cancer surgery are more often than not unaware or surprised to learn that the surgery had exposed them to the risk of these problems.

The data for the study was obtained from the men who came to a sexual health clinic seeking help for sexual dysfunction, post removal of a cancerous prostate gland. When the researches spoke to the men about the sexual function information they had been given before the operation, they learnt that the men had "largely unrealistic expectations" about their sexual abilities post operatively like whether they would be able to get erections.

Dr. Joshua Meeks, a urologist affiliated with the Northwestern University Feinberg School of Medicine in Chicago says, "I think this data is some of the first to report what we see in the clinic."

According to senior study author Dr. John P. Mulhall and colleagues at Memorial Sloan Kettering Cancer Center in New York City, various treatment options are available to men with prostate cancer, which include active surveillance, radiation and prostatectomy. None of the options are free of potential side effects though.

As per the report available online, December 21 in BJU International, Mulhall and colleagues conducted a survey of 336 men with sexual dysfunction roughly three months post radical prostatectomy. Two-thirds of the men had traditional open surgery and the rest had undergone robotic-assisted surgery.

The average age of the men was 64 years and about 88% of open surgery cases and 915 of robotic surgery cases said they'd been able to have sex before surgery.

Only 38% of the patients were aware whether they'd had nerve sparing surgery that helps preserve sexual function. Only half of the patients knew that the surgery would make them incapable of ejaculation. Less than 10% were aware that the length of their penis might decrease post-surgery. In each group, only a few men knew of the possibility for changes in orgasms and pain or incontinence during orgasms.

The researchers would not be able to differentiate between what the patients were actually told and what they remembered as the study did not involve an analysis of any pre-operative instructions or information that the patient might have received from their doctors.

Although not associated with the new study, Meeks states that the one can infer from the results that some men may not remember or retain the information given by their doctor about the risks of prostate removal.

As told to Reuters Health, Meeks says, "I think it really highlights why it's important to have their spouse there, because I think having another set of ears is incredibly helpful."

Another doctor, who too was not involved in this study, Dr. Daniel Shoskes, a urologist at the Cleveland Clinic also stated to Reuters Health that the conclusions fit with what his team has been aware of for some time.

For men undergoing prostrate removal surgery, the Cleveland Clinic has started a half a day class to educate them about the surgery and rehabilitation. Shoskes hopes that the classes will "have an impact on patient retention and satisfaction with the surgery."

Shoskes, goes on to add, "It is human and normal to forget what has been told to you. In some cases, it's the surgeon that needs to do a better job of delivering the information."

We could not get a response to our request for a comment from the study's lead author. However, the study team also has emphasized on the requirement to better prepare men for these surgeries. In the findings in their paper, they write, "the findings should give us reason to think about our approach to the education of the patient prior to radical prostatectomy. Patients are not remembering or appreciating the information the way that it is intended and undertake the operation with mistaken expectations regarding their sexual health."