Feasibility and acceptability of couple counselling and pelvic floor muscle training after operation for prostate cancer

Abstract

Background: Radical prostatectomy is often followed by long-lasting erectile dysfunction and urinary incontinence, with adverse effects on the quality of life and intimate relationship of patients and partners. We developed the ProCan intervention to ameliorate sexual and urological dysfunction after radical prostatectomy and examined its feasibility, acceptability and changes in sexual function.

Material and methods: Between May 2014 and October 2014, seven couples attending the Department of Urology, Rigshospitalet, were included 3–4 weeks after radical prostatectomy in the ProCan intervention, which consists of up to six couple counselling sessions, group instruction in pelvic floor muscle training (PFMT), up to three individual PFMT sessions and a DVD home training program. We examined its feasibility on the basis of the recruitment rate, adherence to and acceptability of the intervention, the response rate and changes in erectile and sexual functioning measured on the International Index of Erectile Function at baseline and at eight and 12 months.

Results: The recruitment rate was 14%. One couple withdrew, six couples attended 1–4 counselling sessions, and all patients attended PFMT until continence was achieved. The response rate on outcomes was 85% for patients and 71% for partners. The couples reported that counselling improved their sex life but it did not improve their ability to talk openly about sex. Most patients found that the physiotherapist improved their motivation and the quality and intensity of PFMT. Erectile dysfunction improved from severe at baseline to moderate at eight months’ follow-up, and mean sexual functioning improved from 18.4 to 37.1 points at eight months’ follow-up, but decreased slightly to 31.4 at 12 months.

Conclusion: Our results suggest that the recruitment procedure should be adapted and minor revisions are needed in the intervention. The key components, couple counselling and PFMT, were well accepted and achievable for the patients.

Acknowledgments

We thank the couples who made this study possible.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical approval

The study was approved by the Danish National Committee for the Capital Region (registration number H-3-2013-206). The trial is registered on ClinicalTrials.gov identifier: NCT02103088.

Funding

The study was funded by the Research Foundation in the Capital Region and the Danish Cancer Society.