MP76-18 “PARTNER PROSTHESIS PANIC”: MANAGEMENT OF FEMALE SEXUAL DYSFUNCTION IN PARTNERS OF MEN UNDERGOING PENILE PROSTHESIS IMPLANTATION

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Medical, Hormonal & Non-surgical Therapy I1 Apr 2016MP76-18 “PARTNER PROSTHESIS PANIC”: MANAGEMENT OF FEMALE SEXUAL DYSFUNCTION IN PARTNERS OF MEN UNDERGOING PENILE PROSTHESIS IMPLANTATION Sherita King, Rose Hartzell, and Irwin Goldstein Sherita KingSherita King More articles by this author , Rose HartzellRose Hartzell More articles by this author , and Irwin GoldsteinIrwin Goldstein More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1869AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES About 30,000 penile implants are placed annually in the US. In our practice, several female partners in monogamous relationships with men with erectile dysfunction (ED) considering implant surgery have expressed significant concern over the re-introduction of an erect penis into their sexual lives. We define “Partner Prosthesis Panic” as the concerns of the female sexual partner who described issues such as: her low sexual desire, reduced arousal, muted orgasm, and bothersome pain during penetration. These conditions may negatively influence post-op outcome and frequency of implant use. We examined prevalence of “Partner Prosthesis Panic” and management strategies of distressed female sexual partners of men undergoing penile prosthesis implantation. METHODS In the last 50 consecutive penile implant surgeries in men in monogamous relationships, we identified 11 (22%) female sexual partners (mean age 57 +/- 11) who expressed “Partner Prosthesis Panic” and underwent management in our facility. RESULTS Contemporary management of women with sexual dysfunction is biopsychosocial including judicious use of FDA-approved and non-approved treatment options. 82% were menopausal, 18% were peri-menopausal. All had sexual dysfunction for >5 years prior to the implant. Female Sexual Function Index (mean 18 +/- 4) and Female Sexual Distress Scale (21 +/- 6) scores were abnormal in all. Psychologic interviews revealed findings consistent with a history of sexual trauma/abuse (27%) and mood issues: anxiety, depression, panic, use of mood-related medications (45%). Pelvic floor exams were abnormal in 73%. Vulvoscopy revealed abnormalities such as clitoral atrophy, resorption of labia minora, erythema/tenderness of minor vestibular glands, limited robust peri-urethral tissue, urethral prolapse, limited gavial rugae, abnormal vaginal pH in all patients. Hormonal assessments of sex steroids were abnormal in all patients. Following sex therapy, physical therapy, and biologic management, 8 of 11 experienced markedly improved sexual function that significantly facilitated couple satisfaction post-penile implantation. CONCLUSIONS Now that the FDA has approved treatments for women with sexual health concerns, management of women with sexual dysfunction, especially in monogamous relationships with men with ED considering penile implant surgery will become more commonplace. To maximize satisfaction following penile implant insertion, sexual medicine care to both individual members of the couple should be offered and provided. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1014 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Sherita King More articles by this author Rose Hartzell More articles by this author Irwin Goldstein More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...