The Relationships Between Preoperative Sexual Desire and Quality of Life Following Radical Prostatectomy: A 5-Year Follow-Up Study

Introduction. There were few studies about the relationship between sexual desire (SD) and radical prostatectomy (RP). Aims. We assessed the relationships between RP and quality of life (QOL) according to the preoperative SD. Main Outcome Measure. General QOL was measured with Short Form 36. Sexual function and bother were measured with the University of California, Los Angeles Prostate Cancer Index (PCI). Changes of postoperative SD were also evaluated using PCI. Methods. We analyzed data from 285 men who underwent RP and were prospectively enrolled into a longitudinal cohort study. Patients were divided into two groups according to whether they had SD at baseline, which is addressed in the PCI questionnaire: a low SD (LSD) group and a high SD (HSD) group. The assessments were completed before treatment and 3, 6, 12, 24, and 60 months after RP. Results. Of the 244 men, 52% had high or a fair level of SD before RP, whereas 48% reported that the level of their SD was low. The HSD group reported better sexual function and sexual bother scores than the LSD group at baseline (both P<0.001). Fifty-one percent of the HSD group reported that SD at 3 months was poor or very poor, which did not return to the preoperative level at all postoperative time points. Nearly 20% of the LSD group regained higher SD after RP than the baseline level. The HSD group showed worse sexual bother scores than the baseline throughout the postoperative follow-up (P<0.001). However, the LSD group demonstrated equivalent sexual bother scores after RP compared with the baseline. Conclusions. RP adversely affected SD as well as sexual function and sexual bother. The patients who had HSD experienced greater distress concerning their sexual dysfunction postoperatively than those with LSD.