Mapping the prevalence and use of questionnaires to detect the neglected sexual side effects after prostate cancer treatment: a scoping review

Abstract Background Early prostate cancer (PCa) treatment interventions may leave men with debilitating sexual side effects, especially when not diagnosed or present at initial follow-up treatment. Men are often embarrassed to disclose their sexual dysfunction. This may lead to sexual side effects related to PCa treatment remaining untreated, adding to their burden of disability. This study was conducted to map the evidence on the prevalence of neglected sexual side effects (NSSE) after radical prostatectomy (RP) surgery or radiation treatment (RT) for PCa treatment and the reported use of questionnaires to identify such side effects. Methods This systematic scoping review’s search strategy involved searching MEDLINE/PubMed, Science Direct and Google Scholar databases. Guided by eligibility criteria, two independent reviewers conducted title, abstract and full-text screening. Data from the included studies were extracted. The review team explored the implications of the findings in relation to the research question and aims of the study. The Mixed Method Appraisal Tool was used to appraise the quality of the included studies. This review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Results Searches of the databases identified 1369 articles, with 23 eventually included for review. The prevalence of NSSE ranged between 0 and 78% in studies reporting on early PCa treatment of RP and RT patients. Orgasmic dysfunction (5–78%), penile curvature changes (10–15.9%) and penile length shortening (0–55%) similarly showed a low to moderate prevalence. Climacturia had low prevalence (4–5.2%) after RT and moderate prevalence (21–38%) after RP, whilst anejaculation had low to high prevalence (11–72%) after RT. No validated questionnaire was used to detect any NSSE after early PCa treatment. Studies mainly modified other questionnaires, and two studies used non-validated questionnaires to identify some NSSE. Participants in the included studies reported being inadequately informed about the possible sexual side effects of their treatment. Conclusion This study showed a low to a high prevalence of NSSE in men after RP and RT for early PCa treatment. Questionnaires helped detect individual NSSEs after PCa treatment but there is currently no evidence of a valid, reliable and comprehensive questionnaire to detect the NSSE collectively. Scoping review registration N/A

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The Prevalence and the Use of the Questionnaire’s Related to the Neglected Sexual Side Effects After Prostate Cancer Treatment: A Scoping Review of the Literature

10.21203/rs.3.rs-34562/v1 ◽

2020 ◽

Author(s):

Pierre Röscher ◽

Ronisha Sathiram ◽

Joanne E Milios ◽

Jacqueline M van Wyk

Keyword(s):

Prostate Cancer ◽

Side Effects ◽

Radiation Treatment ◽

Research Question ◽

Eligibility Criteria ◽

Sexual Side Effects ◽

Validated Questionnaire ◽

Review Team ◽

Collective Group ◽

Orgasmic Dysfunction

Abstract Background: Early prostate cancer (PCa) treatment interventions may leave men with debilitating sexual side effects. These side effects may remain permanent, often undiagnosed, and undermanaged. The objective of this study was to map the evidence pertaining to the prevalence, and use of questionnaires, related to the neglected sexual side effects (NSSE) after PCa treatment consisting of radical prostatectomy (RP) surgery or radiation treatment (RT).Methods: This systematic scoping review’s search strategy involved the search of PubMed, Science Direct, and Google Scholar databases. Following title searching, two-independent reviewers conducted screening of abstracts and full articles. The screenings were guided by the eligibility criteria. Data were extracted from the included studies and the emerging themes were analysed. The review team analysed the implications of the findings in relation to the research question and aims of the study. The Mixed Method Appraisal Tool was employed for quality appraisal of included studies.Discussion: Twenty-three studies about the prevalence and questionnaire use for NSSE after early PCa treatment were included. Two studies investigated most of the collective group of NSSE’s, and all the other studies mostly looked at a single NSSE. No single validated questionnaire was found that investigates the NSSE after early PCa treatment. Most studies incorporated some aspects of other questionnaires. Two studies used non-validated questionnaires that picked up on the majority of the collective group of NSSE.Conclusion: NSSEs are prevalent in men after RP and RT. Peyronie’s Disease, orgasmic Dysfunction and Penile Length Shortening are all similarly prevalent after RP and RT. Anejaculation was only found to be prevalent after RT*. Orgasm associated incontinence resulted from RP and RT, but the prevalence in RP patients was 6 times that of RT patients. Study participants felt inadequately informed about possible sexual side effects caused by their treatment choices. Questionnaires are effective at detecting NSSE after PCa treatment, but there is no valid and reliable questionnaire currently available to detect all the collective NSSE after PCa treatment. There is a scope to develop a validated and reliable PCa NSSE questionnaire. The NSSE questionnaire must be quick, straightforward, and effective.

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Mapping the prevalence of the neglected sexual side effects after prostate cancer treatment and the questionnaires used in their screening: a scoping review protocol

Systematic Reviews ◽

10.1186/s13643-020-01473-9 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Pierre Röscher ◽

Jacqueline M. van Wyk

Keyword(s):

Prostate Cancer ◽

Side Effects ◽

Scoping Review ◽

Research Question ◽

Prostate Cancer Treatment ◽

Eligibility Criteria ◽

Sexual Stimulation ◽

Sexual Side Effects ◽

Review Team ◽

Review Protocol

Abstract Background Interventions to treat early prostate cancer (PCa) can leave men with debilitating sexual side effects. The cluster of side effects referred to as the neglected sexual side effects (NSSE) may remain permanent, undiagnosed and untreated because men are hesitant to disclose them. Questionnaires offer a discreet way into the discussion, subsequent diagnosis and possible treatment of the NSSE. This study will be conducted to map the evidence about the prevalence of the neglected sexual side effects (NSSE) after PCa treatment, and use of questionnaires in its diagnosis and screening. Methods This systematic scoping review will involve searching the following electronic databases: PubMed, Science Direct and Google Scholar. Following title searching, two-independent reviewers will conduct screening of abstracts and full articles. Eligibility criteria will guide the screenings. Data will be extracted from the included studies, and the emerging themes will be analysed. The review team will analyse the implications of the findings concerning the research question and aim of the study. The mixed method appraisal tool (MMAT) will be employed for quality appraisal of included studies. Discussion We anticipate finding a number of studies that describe the prevalence of NSSE after early PCa treatment and that report on using questionnaires to screen for the presence of symptoms including orgasm-associated incontinence, urinary incontinence during sexual stimulation, altered perceptions of orgasm, orgasm associated pain, penile shortening and penile deformity. The study findings will be disseminated through publication in a peer-reviewed journal, peer presentations and presentations at relevant conferences.

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Mapping the prevalence of the neglected sexual side effects after prostate cancer treatment and the questionnaires used in their screening: A scoping review protocol

10.21203/rs.3.rs-27667/v4 ◽

2020 ◽

Author(s):

Pierre Roscher ◽

Jacqueline M Van Wyk

Keyword(s):

Prostate Cancer ◽

Side Effects ◽

Scoping Review ◽

Research Question ◽

Prostate Cancer Treatment ◽

Eligibility Criteria ◽

Sexual Stimulation ◽

Sexual Side Effects ◽

Review Team ◽

Review Protocol

Abstract Background: Interventions to treat early prostate cancer (PCa) can leave men with debilitating sexual side effects. The cluster of side effects referred to as the neglected sexual side effects (NSSE) may remain permanent, undiagnosed and untreated because men are hesitant to disclose them. Questionnaires offer a discreet way into the discussion, subsequent diagnosis and possible treatment of the NSSE. This study will be conducted to map the evidence about the prevalence of the neglected sexual side effects (NSSE) after PCa treatment, and use of questionnaires in its diagnosis and screening. Methods: This systematic scoping review will involve searching the following electronic databases: PubMed, Science Direct and Google Scholar. Following title searching, two-independent reviewers will conduct screening of abstracts and full articles. Eligibility criteria will guide the screenings. Data will be extracted from the included studies, and the emerging themes will be analysed. The review team will analyse the implications of the findings concerning the research question and aim of the study. The Mixed Method Appraisal Tool (MMAT) will be employed for quality appraisal of included studies.Discussion: We anticipate finding a number of studies that describe the prevalence of NSSE after early PCa treatment and that report on using questionnaires to screen for the presence of symptoms including orgasm-associated incontinence, urinary incontinence during sexual stimulation, altered perceptions of orgasm, orgasm associated pain, penile shortening, and penile deformity. The study findings will be disseminated through publication in a peer-reviewed journal, peer presentations, as well as presentations at relevant conferences.

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Mapping the prevalence of the neglected sexual side effects after prostate cancer treatment and the questionnaires used in their screening: A scoping review protocol

10.21203/rs.3.rs-27667/v3 ◽

2020 ◽

Author(s):

Pierre Roscher ◽

Jacqueline M Van Wyk

Keyword(s):

Prostate Cancer ◽

Side Effects ◽

Research Question ◽

Prostate Cancer Treatment ◽

Eligibility Criteria ◽

Sexual Stimulation ◽

Sexual Side Effects ◽

Review Team ◽

Review Protocol ◽

Appraisal Tool

Abstract Background: Interventions to treat early prostate cancer (PCa) can leave men with debilitating sexual side effects. The cluster of side effects referred to as the neglected sexual side effects (NSSE) may remain permanent, undiagnosed and untreated because men are hesitant to disclose them. Questionnaires offer a discreet way into the discussion, subsequent diagnosis and possible treatment of the NSSE. This study will be conducted to map the evidence about the prevalence of the neglected sexual side effects (NSSE) after PCa treatment, and use of questionnaires in its diagnosis and screening. Methods: This systematic scoping review's search strategy will involve the following electronic databases: PubMed, Science Direct and Google Scholar. Following title searching, two-independent reviewers will conduct screening of abstracts and full articles. Eligibility criteria will guide the screenings. Data will be extracted from the included studies, and the emerging themes will be analysed. The review team will analyse the implications of the findings concerning the research question and aim of the study. The Mixed Method Appraisal Tool (MMAT) will be employed for quality appraisal of included studies.Discussion: We anticipate finding a number of studies that describe the prevalence of NSSE after early PCa treatment and that report on using questionnaires to screen for the presence of symptoms including orgasm-associated incontinence, urinary incontinence during sexual stimulation, altered perceptions of orgasm, orgasm associated pain, penile shortening, and penile deformity. The study findings will be disseminated through publication in a peer-reviewed journal, peer presentations, as well as presentations at relevant conferences.

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The prevalence of the Neglected Sexual Side Effects (NSSEs) after early prostate cancer treatment and the role of a questionnaire in its diagnosis: A Scoping Review Protocol

10.21203/rs.3.rs-27667/v1 ◽

2020 ◽

Author(s):

Pierre Roscher ◽

Jacqueline M Van Wyk

Keyword(s):

Prostate Cancer ◽

Side Effects ◽

Research Question ◽

Eligibility Criteria ◽

Treatment Interventions ◽

Early Prostate Cancer ◽

Sexual Side Effects ◽

Review Team ◽

Review Protocol

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The prevalence of the Neglected Sexual Side Effects (NSSEs) after early prostate cancer treatment and the role of a questionnaire in its diagnosis: A Scoping Review Protocol

10.21203/rs.3.rs-27667/v2 ◽

2020 ◽

Author(s):

Pierre Roscher ◽

Jacqueline M Van Wyk

Keyword(s):

Prostate Cancer ◽

Side Effects ◽

Research Question ◽

Eligibility Criteria ◽

Treatment Interventions ◽

Early Prostate Cancer ◽

Sexual Side Effects ◽

Review Team ◽

Review Protocol

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Establishing Consensus on a Screening Tool for the Neglected Sexual SIde Effects after Prostate Cancer Treatment: A Modified E-Delphi Study.

10.21203/rs.3.rs-181035/v1 ◽

2021 ◽

Author(s):

Pierre Roscher ◽

Kimesh Naidoo ◽

Joanne Milios ◽

Jacqueline van Wyk

Keyword(s):

Prostate Cancer ◽

Side Effects ◽

Cancer Treatment ◽

Delphi Study ◽

Screening Tool ◽

Penile Curvature ◽

Prostate Cancer Treatment ◽

Modified Delphi ◽

Sexual Side Effects ◽

Strongly Agree

Abstract BackgroundNeglected sexual side effects are a group of less common sexual side effects after Prostate that may present after Prostate Cancer treatment. There is currently no valid and reliable tool to identify these side effects. A modified Delphi study is an effective way of developing and validating such a screening tool.MethodsA modified Delphi study was used to obtain consensus from a multi-disciplinary group of experts over three rounds. Ten statements were presented containing 8 close ended statements on individual NSSEs, and 2 open ended statements on Psychosocial impact related to NSSE. Consensus was defined as a 75% strongly agree achievement on each statement, or the final statement evolution at the end of 3 rounds. Statement support in each round was determined by mean, standard deviation and range, after a numerical value was allocated to each statement during specific rounds. All three rounds were structured and suggestions and additions were incorporated in the statement evolution of the three rounds.ResultsThirty five participants were invited, and 27 completed Round 1(RD 1), 23 participants completed RD2, and 20 participants completed RD3. All 3 rounds were completed in 12 weeks. Statement 1(sexual arousal incontinence), statement 2(climacturia) and statement 3 (orgasm intensity) reached consensus after RD2, and statement 9 (sexual dysfunction impact) and statement 10 (experiences) were removed after RD3. Statement 4 (orgasmic pain), statement 5 (anejaculation), statement 6(sensory disturbances), statement 7 (penile length shortening) and statement 8 (penile curvature) were finalised after the conclusion of RD3. Statement 1-3 were the most stable statements with the most support and least amount of disagreement. Statements 4-8 were less stable, but support for them improved over the 3 rounds. Statement 9-10 both had good stability, but the support indicated that they needed to be removed from the set of statements. Statement 5 had the poorest range due to an outlier opinion.ConclusionsConsensus was reached on the statements making up the NSSE screening tool. Health care practitioners will be able to use this tool to identify NSSE after prostate cancer treatment. Further reliability testing on this tool is needed.

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