Guidelines for Sexual Health Care for Prostate Cancer Patients

Autor: Daniela Wittmann, Akanksha Mehta, Eilis McCaughan, Martha Faraday, Ashley Duby, Andrew Matthew, Luca Incrocci, Arthur Burnett, Christian J. Nelson, Stacy Elliott, Bridget F. Koontz, Sharon L. Bober, Deborah McLeod, Paolo Capogrosso, Tet Yap, Celestia Higano, Stacy Loeb, Emily Capellari, Michael Glodé, Heather Goltz, Doug Howell, Michael Kirby, Nelson Bennett, Landon Trost, Phillip Odiyo Ouma, Run Wang, Carolyn Salter, Ted A. Skolarus, John McPhail, Susan McPhail, Jan Brandon, Laurel L. Northouse, Kellie Paich, Craig E. Pollack, Jen Shifferd, Kim Erickson, John P. Mulhall
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Journal of Sexual Medicine. 19(11):1655-1669
ISSN: 1743-6095
DOI: 10.1016/j.jsxm.2022.08.197
Popis: Background Patients with prostate cancer suffer significant sexual dysfunction after treatment which negatively affects them and their partners psychologically, and strain their relationships. Aim We convened an international panel with the aim of developing guidelines that will inform clinicians, patients and partners about the impact of prostate cancer therapies (PCT) on patients’ and partners’ sexual health, their relationships, and about biopsychosocial rehabilitation in prostate cancer (PC) survivorship. Methods The guidelines panel included international expert researchers and clinicians, and a guideline methodologist. A systematic review of the literature, using the Ovid MEDLINE, Scopus, CINAHL, PsychINFO, LGBT Life, and Embase databases was conducted (1995–2022) according to the Cochrane Handbook for Systematic Reviews of Interventions. Study selection was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Each statement was assigned an evidence strength (A-C) and a recommendation level (strong, moderate, conditional) based on benefit/risk assessment. Data synthesis included meta-analyses of studies deemed of sufficient quality (3), using A Measurement Tool to Assess Systematic Reviews (AMSTAR). Outcomes Guidelines for sexual health care for patients with prostate cancer were developed, based on available evidence and the expertise of the international panel. Results The guidelines account for patients’ cultural, ethnic, and racial diversity. They attend to the unique needs of individuals with diverse sexual orientations and gender identities. The guidelines are based on literature review, a theoretical model of sexual recovery after PCT, and 6 principles that promote clinician-initiated discussion of realistic expectations of sexual outcomes and mitigation of sexual side-effects through biopsychosocial rehabilitation. Forty-seven statements address the psychosexual, relationship, and functional domains in addition to statements on lifestyle modification, assessment, provider education, and systemic challenges to providing sexual health care in PC survivorship. Clinical Implications The guidelines provide clinicians with a comprehensive approach to sexual health care for patients with prostate cancer. Strengths & Limitations The strength of the study is the comprehensive evaluation of existing evidence on sexual dysfunction and rehabilitation in prostate cancer that can, along with available expert knowledge, best undergird clinical practice. Limitation is the variation in the evidence supporting interventions and the lack of research on issues facing patients with prostate cancer in low and middle-income countries. Conclusion The guidelines document the distressing sexual sequelae of PCT, provide evidence-based recommendations for sexual rehabilitation and outline areas for future research.
Databáze: OpenAIRE