SEXOLOGICAL PROBLEMS AFTER CYSTECTOMY - BLADDER SUBSTITUTION COMPAREDWITH ILEAL CONDUIT DIVERSION - A QUESTIONNAIRE STUDY OF MALE-PATIENTS

A questionnaire study was carried out to compare the postoperative sex ological problems after cystectomy and bladder substitution using the urethral Kock reservoir or the ileocecal reservoir with that following ileal conduit diversion. A total of 76 male patients with bladder can cer completed the questionnaire: 49 patients had a bladder substitutio n and 27 an ileal conduit diversion. Median follow-up was 1.3 years (r ange 0.5-6.4) and 4.8 years (range 2.4-14.7), respectively. Only 9% of all patients could achieve an erection at least every second time, in comparison to 82% preoperatively. Thirty-eight percent of all patient s were able to achieve orgasm, and 26% were coitally active to some de gree. Reasons for decrease or cessation of coitus were loss of potency among 77% and 96% respectively (p = 0.04), while those reporting decr eased libido (29%), partner refusal (13%), and feeling less sexually a ttractive (20%) showed no between-group differences. Regression analys is showed no influence of type of operation, while age above 68 years influenced orgasmic ability and coital activity, and radiation treatme nt influenced whether the patient felt less sexually attractive than b efore surgery.