Abstract：
Patients with prostate cancer suffer significant sexual dysfunction after treatment which negatively affects them and their partners psychologically, and strain their relationships.
We convened an international panel with the aim of developing guidelines that will inform clinicians, patients and partners about the impact of prostate cancer therapies (PCT) on patients\' and partners\' sexual health, their relationships, and about biopsychosocial rehabilitation in prostate cancer (PC) survivorship.
The guidelines panel included international expert researchers and clinicians, and a guideline methodologist. A systematic review of the literature, using the Ovid MEDLINE, Scopus, CINAHL, PsychINFO, LGBT Life, and Embase databases was conducted (1995-2022) according to the Cochrane Handbook for Systematic Reviews of Interventions. Study selection was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Each statement was assigned an evidence strength (A-C) and a recommendation level (strong, moderate, conditional) based on benefit/risk assessment, according to the nomenclature of the American Urological Association (AUA). Data synthesis included meta-analyses of studies deemed of sufficient quality (3), using A Measurement Tool to Assess Systematic Reviews (AMSTAR).
Guidelines for sexual health care for patients with prostate cancer were developed, based on available evidence and the expertise of the international panel.
The guidelines account for patients\' cultural, ethnic, and racial diversity. They attend to the unique needs of individuals with diverse sexual orientations and gender identities. The guidelines are based on literature review, a theoretical model of sexual recovery after PCT, and 6 principles that promote clinician-initiated discussion of realistic expectations of sexual outcomes and mitigation of sexual side-effects through biopsychosocial rehabilitation. Forty-seven statements address the psychosexual, relationship, and functional domains in addition to statements on lifestyle modification, assessment, provider education, and systemic challenges to providing sexual health care in PC survivorship.
The guidelines provide clinicians with a comprehensive approach to sexual health care for patients with prostate cancer.
The strength of the study is the comprehensive evaluation of existing evidence on sexual dysfunction and rehabilitation in prostate cancer that can, along with available expert knowledge, best undergird clinical practice. Limitation is the variation in the evidence supporting interventions and the lack of research on issues facing patients with prostate cancer in low and middle-income countries.
The guidelines document the distressing sexual sequelae of PCT, provide evidence-based recommendations for sexual rehabilitation and outline areas for future research. Wittmann D, Mehta A, McCaughan E, et al. Guidelines for Sexual Health Care for Prostate Cancer Patients: Recommendations of an International Panel. J Sex Med 2022;19:1655-1669.
We convened an international panel with the aim of developing guidelines that will inform clinicians, patients and partners about the impact of prostate cancer therapies (PCT) on patients\' and partners\' sexual health, their relationships, and about biopsychosocial rehabilitation in prostate cancer (PC) survivorship.
The guidelines panel included international expert researchers and clinicians, and a guideline methodologist. A systematic review of the literature, using the Ovid MEDLINE, Scopus, CINAHL, PsychINFO, LGBT Life, and Embase databases was conducted (1995-2022) according to the Cochrane Handbook for Systematic Reviews of Interventions. Study selection was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Each statement was assigned an evidence strength (A-C) and a recommendation level (strong, moderate, conditional) based on benefit/risk assessment, according to the nomenclature of the American Urological Association (AUA). Data synthesis included meta-analyses of studies deemed of sufficient quality (3), using A Measurement Tool to Assess Systematic Reviews (AMSTAR).
Guidelines for sexual health care for patients with prostate cancer were developed, based on available evidence and the expertise of the international panel.
The guidelines account for patients\' cultural, ethnic, and racial diversity. They attend to the unique needs of individuals with diverse sexual orientations and gender identities. The guidelines are based on literature review, a theoretical model of sexual recovery after PCT, and 6 principles that promote clinician-initiated discussion of realistic expectations of sexual outcomes and mitigation of sexual side-effects through biopsychosocial rehabilitation. Forty-seven statements address the psychosexual, relationship, and functional domains in addition to statements on lifestyle modification, assessment, provider education, and systemic challenges to providing sexual health care in PC survivorship.
The guidelines provide clinicians with a comprehensive approach to sexual health care for patients with prostate cancer.
The strength of the study is the comprehensive evaluation of existing evidence on sexual dysfunction and rehabilitation in prostate cancer that can, along with available expert knowledge, best undergird clinical practice. Limitation is the variation in the evidence supporting interventions and the lack of research on issues facing patients with prostate cancer in low and middle-income countries.
The guidelines document the distressing sexual sequelae of PCT, provide evidence-based recommendations for sexual rehabilitation and outline areas for future research. Wittmann D, Mehta A, McCaughan E, et al. Guidelines for Sexual Health Care for Prostate Cancer Patients: Recommendations of an International Panel. J Sex Med 2022;19:1655-1669.
摘要：
前列腺癌患者在治疗后出现明显的性功能障碍，这对他们和他们的伴侣在心理上产生了负面影响，紧张他们的关系。
我们召集了一个国际小组，旨在制定指导临床医生的指南，患者和伴侣了解前列腺癌治疗（PCT）对患者和伴侣性健康的影响，他们的关系,以及前列腺癌（PC）幸存者的生物心理社会康复。
指南小组包括国际专家研究人员和临床医生，和指导方法学家。对文献进行了系统的回顾，使用OvidMEDLINE,Scopus,CINAHL,心理信息,LGBT生活,根据Cochrane干预措施系统审查手册进行了Embase数据库（1995-2022年）。研究选择基于系统评价和荟萃分析（PRISMA）指南的首选报告项目。每个陈述都被分配了一个证据强度(A-C)和一个建议级别(强，中度,有条件)基于利益/风险评估。数据综合包括对被认为质量足够的研究的荟萃分析(3)，使用测量工具评估系统评论(AMSTAR)。
制定了前列腺癌患者性健康护理指南，基于现有证据和国际小组的专业知识。
指南对患者的文化、民族,种族多样性。他们关注具有不同性取向和性别认同的个人的独特需求。该指南基于文献综述，PCT术后性恢复的理论模型，和6个原则，促进临床医生发起的对性结果的现实期望的讨论，并通过生物心理社会康复减轻性副作用。47份声明涉及性心理，关系,和功能领域，除了关于生活方式改变的声明，评估，提供者教育，以及在PC幸存者中提供性健康护理的系统性挑战。
该指南为临床医生提供了全面的前列腺癌患者性健康护理方法。
这项研究的力量是对前列腺癌性功能障碍和康复的现有证据的综合评估，连同可用的专业知识，最好的基础临床实践。局限性在于支持干预措施的证据的差异以及缺乏对低收入和中等收入国家前列腺癌患者面临的问题的研究。
指南记录了PCT令人痛苦的性后遗症，提供基于证据的性康复建议，并概述未来研究的领域。WittmannD,MehtaA,麦考恩·E，etal.前列腺癌患者性保健指南：国际小组的建议。JSexMed2022；19：1655-1669。
我们召集了一个国际小组，旨在制定指导临床医生的指南，患者和伴侣了解前列腺癌治疗（PCT）对患者和伴侣性健康的影响，他们的关系,以及前列腺癌（PC）幸存者的生物心理社会康复。
指南小组包括国际专家研究人员和临床医生，和指导方法学家。对文献进行了系统的回顾，使用OvidMEDLINE,Scopus,CINAHL,心理信息,LGBT生活,根据Cochrane干预措施系统审查手册进行了Embase数据库（1995-2022年）。研究选择基于系统评价和荟萃分析（PRISMA）指南的首选报告项目。每个陈述都被分配了一个证据强度(A-C)和一个建议级别(强，中度,有条件)基于利益/风险评估。数据综合包括对被认为质量足够的研究的荟萃分析(3)，使用测量工具评估系统评论(AMSTAR)。
制定了前列腺癌患者性健康护理指南，基于现有证据和国际小组的专业知识。
指南对患者的文化、民族,种族多样性。他们关注具有不同性取向和性别认同的个人的独特需求。该指南基于文献综述，PCT术后性恢复的理论模型，和6个原则，促进临床医生发起的对性结果的现实期望的讨论，并通过生物心理社会康复减轻性副作用。47份声明涉及性心理，关系,和功能领域，除了关于生活方式改变的声明，评估，提供者教育，以及在PC幸存者中提供性健康护理的系统性挑战。
该指南为临床医生提供了全面的前列腺癌患者性健康护理方法。
这项研究的力量是对前列腺癌性功能障碍和康复的现有证据的综合评估，连同可用的专业知识，最好的基础临床实践。局限性在于支持干预措施的证据的差异以及缺乏对低收入和中等收入国家前列腺癌患者面临的问题的研究。
指南记录了PCT令人痛苦的性后遗症，提供基于证据的性康复建议，并概述未来研究的领域。WittmannD,MehtaA,麦考恩·E，etal.前列腺癌患者性保健指南：国际小组的建议。JSexMed2022；19：1655-1669。
