Abstract
BackgroundPatient-reported outcomes have become increasingly important to assess the value of surgical procedures. Sexual function is a proven important constituent of quality of life, but is often overlooked by health care professionals. We aim to investigate to what extent plastic surgeons address or discuss issues concerning sexuality with their patients, and if there is a need for improvement.MethodsWe developed a survey to assess whether topics pertaining to sexual function were discussed during plastic surgical consultations. In 2016, all 385 members of the Dutch Association for Plastic Surgery were invited via post mail to participate.ResultsWe received 106 completed surveys (27.5%). The median age of the respondents was 45 (29–66) years. Most participants (78.3%) indicated that they rarely to never discuss sexuality with their patients. Surgeons in the subspecialization gender and genital surgery discussed sexual function most frequently. Two thirds of all respondents indicated that their current knowledge on this topic was insufficient, yet there was generally no interest expressed in receiving additional training (78.6%). However, there was a need for proper patient brochures (43.4%) and an organized referral network (36.5%) regarding sexuality.ConclusionsIn plastic surgery practice, sexuality appears to be a rarely discussed subject, with the gender and genital surgery subspecialties as the exception. Although professionals and patients emphasize the importance of sexuality, plastic surgeons express limited urge to be trained and prefer written patient information and referring patients to other healthcare professionals. The authors stimulate more education on sexuality during (continued) plastic surgery training.Level of Evidence: Not ratable
Highlights
Health care is increasingly being assessed by the outcomes as experienced by patients
Plastic surgeons experienced uncertainty on conversation starters, insufficient training, and limited knowledge as important barriers towards discussing the subject, and viewed the oncological nurse and psychologist as more appropriate team members to raise this topic. These findings will be discussed in the light of (1) the role of sexuality in plastic surgery practice, (2) how current practice on this topic relates to other specialties, (3) what structural barriers towards discussing sexuality in medical practice are currently known, and (4) how clinical services in plastic surgery may be improved regarding our present findings
Findings in our study suggest that there exist structural barriers towards starting the conversation on sexuality within plastic surgery practice
Summary
Health care is increasingly being assessed by the outcomes as experienced by patients. The impact of (surgical) treatments on experienced measures of sexuality (e.g., sexual (dys) function, sexual activity, and satisfaction with sexuality) is only recently being explored and has been. Many plastic surgeons perform cosmetic surgical procedures as well, which are focused on enhancing a patient’s appearance. Plastic and cosmetic surgery treatments typically have direct impact on esthetic appearance and may affect sensation. Outcomes of plastic surgical treatments can be strongly associated with psychosocial factors including one’s body image [5]. Many plastic or cosmetic surgical treatments can impact sexual function, which has been objectified for gynecomastia correction or cleft lip-palate surgery for example [6, 7]. Patient-reported outcomes have become increasingly important to assess the value of surgical procedures.
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