Sexual function following radical prostatectomy: a prospective longitudinal study of cultural differences between Japanese and American men

• Published in: Prostate cancer and prostatic diseases Vol. 11; no. 3; pp. 298 - 302
• Main Authors: Namiki, S, Kwan, L, Kagawa-Singer, M, Tochigi, T, Ioritani, N, Terai, A, Arai, Y, Litwin, M S
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.09.2008; Nature Publishing Group
• Subjects: Adult; Aged; Aged, 80 and over; Antigens; Biomedical and Life Sciences; Biomedicine; Cancer Research; Cancer surgery; Care and treatment; Complications and side effects; Confidence intervals; Cross-Cultural Comparison; Cultural factors; Erectile Dysfunction - epidemiology; Erectile Dysfunction - ethnology; Erectile Dysfunction - etiology; Humans; Japan; Longitudinal Studies; Male; Methods; Middle Aged; original-article; Patient outcomes; Prostate cancer; Prostate-specific antigen; Prostatectomy; Prostatectomy - adverse effects; Prostatectomy - methods; Prostatectomy - rehabilitation; Quality of life; Recovery; Risk factors; Sexual Behavior - physiology; Sexual disorders; Treatment Outcome; United States; Urological surgery; United States; Japan; radical prostatectomy; impotence; quality of life; cross-cultural comparative study; prostatic neoplasms
• ISSN: 1365-7852; 1476-5608; 1476-5608
• DOI: 10.1038/sj.pcan.4501013

We conducted a cross-cultural comparison of the recovery of sexual function and bother during the first 2 years after radical prostatectomy (RP) between American and Japanese men. A total of 275 Japanese and 283 American men who underwent RP alone were prospectively enrolled into longitudinal cohort studies of health-related quality of life outcomes. Sexual function and bother (distress) were estimated with English and validated Japanese versions of the UCLA Prostate Cancer Index before RP and 1, 2–3, 4–6, 12, 18 and 24 months after RP. Each subject served as his own control. Japanese men reported lower sexual function scores at baseline, even after adjusted for age, prostate-specific antigen (PSA) and comorbidity (38 vs 61, P <0.001). The two groups had similar baseline sexual bother (70 vs 69, P =0.84). Japanese men had a smaller improvement in sexual function ( β =0.8 vs β =5.3) and bother ( β =0.2 vs β =2.9) over time than did the American men postoperatively, after adjusting for baseline score, age, baseline PSA and nerve-sparing. American men were more likely than Japanese men to regain their baseline sexual function by 24 months after surgery (hazard ratio (HR)=1.60; 95% confidence interval (CI)=1.06–2.42). In contrast, American men were less likely than Japanese men to return to baseline sexual bother (HR=0.57; 95% CI=0.44–0.75). This study demonstrates that Japanese and American men experience different patterns of recovery of their sexual function and bother after RP. Ethnicity may be a contributing factor.