Sexuality and age: Functioning and quality of life (QoL) in prostate cancer (PC) patients after surgery.

Abstract

e17131 Background: QoL after radical prostatectomy (RP) may impact sexual functioning, with possible differences among age groups. Care management and ability to recognize risks favor the understanding of subjective well-being and Value-based Healthcare (VBHC), measured through PROMs (patient reported outcome measures). Understanding sexual changes between age groups can raise evidence for better understanding functionality and promote rehabilitation approaches. Methods: Prospective, longitudinal, observational, descriptive, quali-quantitative study that evaluated QoL and sexual function associated changes between age groups, before and after RP for PC. The descriptive and functional results were analyzed using data at baseline, 180 (T180) and 365 (T365) days after treatment (ttm), utilizing questions from EPIC26 “quality of your erections”, EORTC QLQ PR25 “use of erection-inducing medications” and Utilization of Sexual Medications/Devices “to what extent were you interested in sex”. Statistical analysis was performed SPSS 2024 software as well as correlation with age and sexual function. Results: Of the 330 patients (pts) followed, 143 were selected for the sample after completing 1 year of surgical ttm. Pathological tumor (pT) classification was ≤T2 in 95 (66%) and ≥T3 in 48 (33%). Fourteen pts (9.8%) needed salvage ttm. The postoperative PSA nadir assessment was <0.2 ng/ml 129 (90.2%), >0.2 ng/ml 10 (7%) and 4 (2.8%) missing pts. According to D’Amico classification, 17 (11.9%) pts presented low, 76 (53.1%) intermediate and 50 (35%) high risk. In quality of erections analysis at baseline, statistically significant differences were observed between age groups: <65, 47 (61%) with erections firm enough for sexual intercourse: and ≥65 years: 14 (73.7%) with erections not firm enough for any sexual activity (p=0.00). Erection medications use was associated with stratification by low and intermediate risk at the time of T365 in the age groups <65 years [26 (57.8%), p=0.07] and ≥65 years [27 (69.2%), p=0.00]. Interest in sex was associated with stratification by low and intermediate risk levels between baseline (p=0.02), T180 (p=0.01) and T365 (p=0.02) in the age group ≥65 years. Among the age group ≥65 years, non-compliance with salvage ttm was statistically distributed between those who reported using medications to aid erections (p=0.0) and those who reported being interested in sex (p=0.0). Conclusions: Age is a determining factor in recovery of sexual function after RP for PC. After 1 year, quality of erections was lower among pts in age group ≥65 years when compared to <65. However, we observed that interest in sex and use of medications that aid erection were present in the age group ≥65 years of those who did not undergo salvage ttm. Investing in early rehabilitation strategies and encouraging the use of therapies can be beneficial in both age groups, aiming better sexuality results.