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Witty, K; Branney, P; Evans, J; Bullen, K; White, A; Eardley, I (2012)
Languages: English
Types: Unknown
Background: Penile cancer is a rare but highly treatable condition. Current guidance recommends the use of a surgical procedure to excise the primary tumour (and a margin of normal penile tissue). Whilst treatment can be effective, treatment often has a significant impact on a patient's sexual and urinary function, and physical and mental wellbeing. The objective of this study was to explore the impact of treatment for penile cancer on sexual function and relationships. Methods: Qualitative data was collected via narrative video interviews. Maximum variation sampling was used to acquire the widest possible range of experiences. All interviews were recorded using either a digital video recorder or digital audio recorder, transcribed. A method of constant comparison analysis was used to illicit themes and outliers. Results: Twenty seven men were interviewed; mean age at diagnosis = 63 (range = 41-82); Mean number of years post-surgery = 3 (range = 0-15 years) 15 men were married, a further two were in a committed relationship, the remaining 10 were single/widowed. All men had received surgical treatment ranging from circumcision to total penectomy. Just two men had attended any form of psychological therapy. The impact of treatment varied considerably. The majority of men talked about still being able to experience arousal and sexual pleasure in some way. However, for many, penetrative sex was awkward and less gratifying than before treatment. One man who had received a total penectomy was surprised to experience a form of orgasm after surgery. For a number of men, the impact of treatment on their ability to satisfy their sexual partners was a key concern. Men who were able to openly talk with their partners about sex and the impact of the treatment on sexual practice found this a great comfort. Conclusion: The significance of sex for a man can differ considerably between individuals; relationship status, age and life stage are all likely to have a bearing on the role that sex plays in a man life. A diagnosis of cancer can also affect how a man (and his partner) views sex and the level of importance which he attaches to it. For men who are sexually active prior to treatment, surgery will undoubtedly result in changes to sexual practice, however, treatment does not have to result in sexual abstinence.
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