Measuring sexual function after treatment for prostate cancer in men who have sex with men: a hidden domain emerges
INTRODUCTION
Treatment for prostate cancer (PCa) can lead to significant impairments in sexual function (SF). Assessing SF both pre- and post-treatment provides an assessment of baseline function and helps measure progress with recovery. Several validated questionnaires exist for measuring SF. However, these instruments were validated using cohorts of men that were predominantly heterosexual. Men who have sex with men (MSM) have different sexual repertoires compared to heterosexual men (HSM) and current instruments may not apply to this population. Our objective was to determine if there are SF domains relevant to MSM that are missed by existing tools.
METHODS
We administered an online self-reported questionnaire to a cohort of 618 men from across the US (285 MSM, 333 HSM) regarding the applicability of the sexual function domain in the validated Expanded Prostate Cancer Index Composite (EPIC) questionnaire. These men were then queried about areas of concern in SF that may have missed by this instrument. Continuous variables were analyzed with a t-test, and a chi-square test was utilized for categorical variables.
RESULTS
The two cohorts were well matched with regard to demographics, including age, race, and education. MSM and HSM found EPIC-SF equally applicable at measuring erectile function (72.61% of MSM and 73.34% of HSM, p=.74). With regard to currently unmeasured domains, a larger number of MSM felt that prostate stimulation was a source of sexual satisfaction for the receptive partner during receptive anal intercourse (RAI) compared to HSM (61.9% vs. 12.77%, p<.0001 a="" larger="" proportion="" of="" msm="" also="" felt="" it="" important="" to="" measure="" sexual="" satisfaction="" with="" rai="" when="" assessing="" function="" after="" pca="" treatment="" vs.="" hsm="" p=".0002)." stratifying="" for="" who="" engaged="" in="" the="" preceding="" year="" did="" not="" msm-rai="" that="" prostate="" stimulation="" was="" source="" during="" and="" more="" thought="" as="" relates="">
CONCLUSION
Currently used instruments measuring SF are applicable to MSM and HSM with regard to erectile function, but fail to measure sexual satisfaction as it relates to RAI, an important area of sexual function for MSM, particularly in MSM who engage in RAI. Our findings highlight the need to add a domain relating to sexual satisfaction from RAI, to help care for and follow sexual minorities treated for PCa.
</.0001>Funding: None