Understanding psychosocial and sexual health concerns among women with bladder cancer undergoing radical cystectomy.

To better understand the physical and psychosocial components of female sexual dysfunction (FSD) among women undergoing radical cystectomy (RC) for bladder cancer (BCa).

We conducted semi-structured individual interviews and a focus group with pre- and post-RC female patients and their partners regarding the impact of RC on sexual health and psychosocial wellbeing. Themes were inductively identified by two independent coders and subsequently organized into themes and subthemes using qualitative description and constant comparison.

In the preoperative cohort, 6 women and 1 partner participated (50% contact rate, 75% participation rate). In the postoperative cohort, 16 women and 2 partners participated (61% contact rate, 64% participation rate). Major themes that emerged in interviews with both cohorts included concerns about changes to body image, the psychological impact of bladder cancer diagnosis and treatment, concerns about the potential impact of RC on sexual function, and inadequacies in provider-led sexual health counseling. Participants varied in the importance they placed on sexual function, with factors such as age, relationship status, and oncologic concerns impacting prioritization, although patients of all ages frequently expressed a desire to retain the option of sexual function.

Female patients with BCa undergoing RC experience changes in body image, psychological distress, physical disruptions in sexual function, and inadequacies in sexual health counseling and education. Future efforts should further study FSD and improve sexual health counseling and the availability of psychosocial support resources.

Urology. 2020 Aug 24 [Epub ahead of print]

Natasha Gupta, Sarah E Van Pilsum Rasmussen, Nora Haney, Armine Smith, Phillip M Pierorazio, Michael H Johnson, Jean Hoffman-Censits, Trinity J Bivalacqua

The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: ., Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA., The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA., The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, MD, USA.