Sexual dysfunction and spousal communication in couples coping with prostate cancer

Objective: To characterize the sexual function of both prostate cancer patients and their partners, and to examine whether associations between sexual dysfunction and psychosocial adjustment vary depending on spousal communication patterns. Methods: In this cross-sectional study, 116 prostate cancer patients and their partners completed psychosocial questionnaires. Results: Patients and partners reported high rates of sexual dysfunction. Within couples, patients' and their partners' sexual function was moderately to highly correlated (r = 0.30-0.74). When patients had poor erectile function, their partners were more likely to report that the couple avoided open spousal discussions; this in turn was associated with partners' marital distress (Sobel's Z = 12.47, p = 0.001). Patients and partners who reported high levels (+ISD) of mutual constructive communication also reported greater marital adjustment, regardless of their own sexual satisfaction. In contrast, greater sexual dissatisfaction was associated with poorer marital adjustment in patients and partners who reported low levels (-ISD) of mutual constructive communication (p < 0.05). Conclusion: Our findings underscore the need for psychosocial interventions that facilitate healthy spousal communication and address the sexual rehabilitation needs of patients and their partners after prostate cancer treatment. Although some couples may be reluctant to engage in constructive cancer-related discussions about sexual problems, such discussions may help alleviate the negative impact that sexual problems have on prostate cancer patients' and their partners' marital adjustment. Copyright (C) 2008 John Wiley & Sons, Ltd.