Sexuality after treatment for early prostate cancer - Exploring the meanings of "erectile dysfunction"

OBJECTIVE: To explore perceptions of the impact of erectile dysfunction on men who had undergone definitive treatment for early nonmetastatic prostate cancer. DESIGN. Seven focus groups of men with early prostate cancer. The groups we re semistructured to explore men's experiences and quality-of-life concerns associated with prostate cancer and its treatment. SETTING: A staff model health maintenance organization, and a Veterans Affa irs medical center. PATIENTS: Forty-eight men who had been treated for early prostate cancer 12 to 24 months previously. RESULTS: Men confirmed the substantial effect of sexual dysfunction on the quality of their lives. Four domains of quality of life related to men's se xuality were identified: 1) the qualities of sexual intimacy; 2) everyday i nteractions with women; 3) sexual imagining and fantasy life; and 4) men's perceptions of their masculinity. Erectile problems were found to affect me n in both their intimate and nonintimate lives, including how they saw them selves as sexual beings. CONCLUSIONS: Erectile dysfunction, the most common side effect of treatment for early prostate cancer, has far-reaching effects upon men's lives. Asse ssment of quality of life related to sexual dysfunction should address thes e broad Impacts of erectile function on men's lives. Physicians should cons ider these effects when advising men regarding treatment options. Physician s caring for patients who have undergone treatment should address these psy chosocial. issues when counseling men with erectile dysfunction.