Factors associated with the decrease in orgasm intensity in patients who underwent to radical prostatectomy

Abstract

ABSTRACT Introduction Orgasmic disorders after radical prostatectomy (RP) surgery have received increasing focus on medical literature, especially the most frequent disorders, to name but a few, climacturia and dysorgasmia. However, changes in orgasm intensity have been reported to non-negligible rates and should be better studied. Objective Our study aims at describing the prevalence and predictors of this neglected symptom. Methods We performed a retrospective analysis of a prospective maintained database of men after RP with complaints of sexual dysfunction. Patients observed a sexual medicine group of our hospital went throught a supervised visit which included the investigation of orgasmic disorders. Other factors such as erectile dysfunction, hypogonadism symptoms, seric level of testosterone and prolactin, and demographics were also recorded. Finally, these variables were correlated with the decrease in orgasm intensity, seeking to assess the existence of predictive factors for this disorder. Results Data from 57 patients were available considering the average age of 67 years old (65,4-68,6 CI, 95%). The decrease in orgasm intensity was reported by 14 patients (24,5%), while climacturia was related to 38 patients (68%) and dysorgasmia to one patient (1,75%). Among patients who experienced decreased orgasm intensity, the average time between the surgery and the search for our service was 27,5 months (15,6-39,4 CI, 95%). After using a logistic regression model adjusted to several variables which include age, time from the last surgery, testosterone and prolactin levels, hypogonadic symptoms, presence of climacturia or dysorgasmia, erectile dysfunction and response to IPDE-5, use of adjuvant radiotherapy or hormonotherapy, it was realized that age was the only factor associated with the lowering of orgasm intensity. The median age was significantly lower in those patients who reported a reduction in orgasm intensity, respectively 62 [59-67] x 68 [64-73] (p <0.01). Conclusions Orgasmic disorders after radical prostatectomy surgery have a high incidence and are often neglected. These symptoms have a direct impact on the quality of life and should be actively investigated. Our study showed that age appears to be a relevant factor associated with this condition. Disclosure Work supported by industry: no.