Psychological functioning quality of life and relationship satisfaction of men who have undergrone penile prosthesis surgery following robot-assisted radical prostatectomy.

Abstract

Introduction: Following radical prostatectomy (RP), many men report dissatisfaction with sexual functioning. Penile prosthesis implantation is deemed to be a last line approach to regaining sexual functioning after RP. Given the lack of Australian data regarding the experience of this group of men, the present study aimed to collect patient-reported outcomes of mental health, sexual function and satisfaction, and relationship satisfaction at a single time-point following prosthesis implantation. Methods: patients were recruited from urology practices in Melbourne, Australia. Participants were men who received a penile prosthesis implant between 6 months and 5 years ago, following RP to treat prostate cancer. Sexual function, anxiety, depression, relationship satisfaction, and satisfaction with prosthesis were assessed using investigator- developed questions and a series of measures: Expanded Prostate Cancer Index (EPIC-26), Patient Health Questionnaire-9, Generalised Anxiety Disorder-7, Self- esteem and Relationship Questionnaire and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS). Data regarding partners' mental health and satisfaction outcomes were also collected. Results: Ninety-four men and their partners were approached to participate in the study. The survey was completed by 70 men and 41 partners. Mean time since surgery was 933 (SD =466) days. Patients reported good sexual function (M=86.19, SD=21.32) and treatment satisfaction scores (M=84.6, SD=16.78) on the EPIC-26 sexual subscale and EDITS scale respectively. Eighty present of men reported no depressive symptoms, while 22% of patients reported at least mild anxiety symptoms. Eighty- nine precent of men believed that it would have been helpful to speak to someone else who had undergone the procedure, prior to making their decision to undergo surgery. Conclusions: Most men reported being satisfied with sexual outcomes following the penile prosthesis surgery. Low levels of anxiety and depressive symptoms were reported. the collected data will enable clinicians to provide more comprehensive pre-operative counselling to men considering this procedure.