Culture, gender, and sexual function research

If you want to be able to understand how certain types of treatment for prostate cancer (and other diseases) affect sexual function, you need to be able to define and understand the sexual functionality of couples prior to any treatment as well as post-treatment. However, this is not something that patients or their partners necessarily greet with enthusiasm!

An Italian research team has just published data from an attempt to assess sexual health issues of prostate cancer patients before and after the man underwent radical prostatectomy (RP). The base population for the study was a cohort of 3,282 consecutive patients scheduled to undergo RP. The authors imply that in all cases at least the patient indicated that he was in a stable heterosexual relationship.

During the first part of the study (Period 1), at the time of admission to the hospital, the initial 1,360 consecutive patients were asked to complete the International Index of Erectile Function (IIEF). During the second part of the study (Period 2), the next 1,171 patients were also asked to complete the IIEF immediately prior to surgery, and the patients’ partners were invited to complete the Female Sexual Function Index (FSFI). During the final phase of the study (Period 3), the final 751 patients were asked to complete the IIEF.

The bottom line was that significantly less than half the patients and even fewer of their partners were willing to complete these questionnaires (even assuming that the information provided was actually accurate). We can summarize the results as follows:

  • During Period 1, 583/1,360 patients (42.9 percent) completed the IIEF.
  • During Period 2, 290/1,171 patients (24.8 percent) completed the IEEF.
  • During Period 3, 261/751 patients (34.8 percent) completed the IEEF.
  • Also during Period 2, only 82/1,171 partners (7.0 percent) partners were willing to fill out the FSFI and of those 82 partners, only 6 women provided complete data.

Salonia et al. conclude (bluntly) that, “The investigation of sexual health issues of both partners prior to RP is largely unsuccessful.”

The “New” Prostate Cancer InfoLink thinks that there may be some cultural factors at play here. Men and women from certain cultures are perhaps less likely to be willing to complete these types of questionnaire than the average American couple, but on the whole we’d be surprised if Italian men and women were particularly unusual in this context (by comparison with men and women in predominantly Islamic cultures, for example, where it might well be considered utterly inappropriate to even invite people to complete this type of questionnaire). The fact of the matter is that we are all (generally) somewhat uncomfortable with this type of inquiry into our sexual functions — and even when we cooperate, we may have a tendency to “shade the truth” (just a tiny little bit).

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