Survivors of non-muscle-invasive bladder cancer (NMIBC) experience a number of sexual problems, including erectile dysfunction and vaginal dryness, recent research shows.
However, strong communication between a couple can alleviate some of those issues.
The study was conducted by a team of American researchers. They pointed out that about 75% of the 70,000 bladder cancer cases diagnosed in the United States each year are NMIBC cases. However, most of the previous research on sexual dysfunction among bladder cancer patients has focused on patients who have had all or part of the bladder removed. There has been little research on how NMIBC patients are affected sexually.
The researchers conducted this study in two parts.
First, 117 NMIBC survivors participated in a quantitative survey. This process included several questionnaires designed to evaluate quality of life, illness intrusiveness, psychological distress, and partner communication. Questions on sexual activity covered the previous four weeks.
Second, the researchers interviewed 26 NMIBC patients to learn more about their sexual function and activities. There was no overlap of participants between the two study components.
On average, the participants in both groups were in their mid-to-late sixties. The majority were male and most were married.
Approximately 55% of the surveyed patients said that their illness and treatment had caused relationship problems. About 39% said they had had no sexual activity in the past four weeks. Women were less likely to be sexually active than men.
Many of the sexually active men had problems with erection and ejaculation. For sexually active women, vaginal dryness was common.
Results from the interviewees were similar. About half had some degree of sexual dysfunction and two-thirds said their situation had caused relationship problems.
Almost a quarter of the surveyed participants and over a third of those interviewed were concerned that sex would transmit either cancer or treatment substances to a partner. One interviewee remarked, “I was leery of having had that chemical in there not knowing what it was.”
Patients and partners who could communicate openly about their situation tended to be more sexually active, although only one-fifth of the survey respondents said they shared all of their concerns.
Some patients accepted that they needed to make adjustments. “[We have sex] weekly,” one interviewee said. “It’s more careful now…I make sure that I have on a fresh pad so I have plenty of room if I should squirt…In fact, [my husband is] kind of amused with the whole thing sometimes. I say oh…I think I’m leaking. Hahaha. He says well you sprung a leak.”
The passage of time also appeared to help. The authors explained that sexual problems associated with NMIBC and its treatment could spark feelings of grief and mourning. They thought that perhaps the study participants who were more interested in sex were “farther along in their grief process.”
They encouraged clinicians to help their patients understand the sexual impact of NMIBC and its treatment, especially if they are concerned about harming a partner through sexual activity. Sex therapists may help couples communicate more effectively and suggest ways to make adjustments in the bedroom.
The study was first published online in April in Sexual Medicine.
Resources
Sexual Medicine
Kowalkowski, Marc A., PhD, et al.
“Examining Sexual Dysfunction in Non-Muscle-Invasive Bladder Cancer: Results of Cross-Sectional Mixed-Methods Research”
(Full-text. First published online: April 3, 2014)
http://onlinelibrary.wiley.com/doi/10.1002/sm2.24/abstract