Why has sexuality research in women with bladder cancer undergoing radical cystectomy been ignored for so long?

Abstract

The impact of invasive bladder cancer treatment in women has historically been an overlooked area of focus. By the end of 2022, there were an estimated 19, 480 new bladder cancer diagnoses among women.1 The impact of bladder cancer treatment on quality of life cannot be understated, in particular the effect of radical cystectomy (RC) on a woman’s sexuality, as this procedure traditionally involves removal of the anterior vaginal wall, urethra, uterus, bilateral fallopian tubes and ovaries. However, despite the obvious consequences such radical surgery for bladder cancer may have on sexual function, this topic of inquiry has been investigated in only a limited number of studies. In fact, from 1992 to 2002, only approximately 13 reports of results were available on the MEDLINE database, with each proceeding decade producing twice as many articles as the decade prior. Here, we aim to provide an outline for such disparities that covers differences in epidemiology, research in surgical techniques, prioritization of oncologic over sexual function outcomes, lack of appropriate counseling, and failure to properly characterize sexual dysfunction in women.