(075) PSYCHOLOGICAL IMPACT OF THE DIAGNOSIS OF UROLOGIC CANCER ON MALE SEXUALITY
Authors: Barros R , Fosse Jr. A , Mangas G , Ninis T , Damo E , Mesquita E , Soyka F , Carvalho J , Favorito L 
Published: December 2024

Abstract

Introduction
Urological neoplasms often affect male sexuality, especially due to the physical consequences of their various therapeutic approaches, particularly in cases of prostate, testicle, and penile tumors. However, the diagnosis of cancer can profoundly affect the emotional well-being of oncology patients, even in cases involving non-reproductive neoplasms.

Objective
The objective of this study was to assess the impact of a urological neoplasm diagnosis on the sexuality of adult men and evaluate the patient’s perception of the healthcare professional’s approach regarding sexuality at the time of diagnosis.

Methods
Adult men diagnosed with urological neoplasms, that visited two urology cancer centers between October 2022 and april 2024, underwent interviews using a semi-structured questionnaire prepared by the research team for the collection of objective clinical data. Data were analyzed using RStudio software. Observation of the association between each qualitative variable was conducted using the chi-square test (95% confidence interval). This study was approved by the ethical committee for human experimentation of our university.

Results
A total of 211 patients were included in this study, with an age range of 22 to 85 years (mean = 65.4). Among these patients, the diagnoses included prostate neoplasms in 167 cases (79.1%), bladder neoplasms in 21 cases (9.9%), kidney neoplasms in 9 cases (4.2%), testicle neoplasms in 8 cases (3.7%), and penis neoplasms in 6 cases (2.8%). Sexual activity was considered important by 191 (90.5%) patients. The majority of patients, 160 (75.8%), decreased sexual frequency after diagnosis. In contrast, 49 patients (23.2%) maintained their pre-diagnosis frequency, while only two patients (0.9%) reported an increase. Ninety-nine (46.9%) patients experienced the onset of anxiety or depression. Additionally, 152 patients (72%) developed various fears, with 108 (51.1%) expressing fear of losing their ability to maintain an erection, and 60 (28.4%) fearing the possibility of transmitting cancer to their partner. Only 49 (23.2%) doctors clearly discussed issues related to sexuality at the time of diagnosis. Forty-one (19.4%) provided only superficial coverage of this topic, and 121 (57.3%) did not mention the subject at all. In terms of patient satisfaction, 92 individuals (43.6%) expressed contentment with their doctors’ approach, while 119 (56.3%) were dissatisfied. There was a statistically significant correlation between patient satisfaction with medical care when it clearly addressed aspects of sexuality (p = 0.001). Moreover, there was a statistically significant association between satisfaction with the medical approach and the tumor site. Bladder tumor patients reported higher satisfaction, whereas prostate and penile cancer patients expressed greater dissatisfaction (p = 0.003).

Conclusions
Sexual problems are not limited to those with genital urological cancer and can also affect patients with kidney and bladder cancer. The negative impact on male sexuality begins at the time of diagnosis, probably due to anxiety, depression and fears related to cancer and its treatment. Therefore, providing empathetic support, sexual education and multidisciplinary care are extremely important for these patients.

Disclosure
No.