Daniela Wittmann, PhD

Couples’ Sexual Recovery After Surgery for Prostate Cancer: The Development of a Conceptual Model

This multiple manuscript dissertation addresses a gap in the literature on couples’ sexual recovery after surgery for prostate cancer. The theoretical framework of the research described is a biopsychosocial model of sexuality with grief as a process through which couples work on recovery.

The first qualitative study describes couples’ anticipation of the sexual recovery and their actual experience after surgery. The study findings support the theoretical framework in which couples experience the effect of the side-effects of prostate cancer surgery on the biopsychosocial aspects of sexuality and cope more or less successfully with the sexual losses through grief and mourning which starts at diagnosis. Female partners’ interest in sex, regardless of menopausal status of their sexual function, makes a contribution to the recovery.

The second study, also qualitative, describes patients’ and partners’ view of the role of the partner in the sexual recovery. Men and partners have many common perceptions of the role, including the importance of the partner’s interest in sex regardless of menopause. However, men are not aware of partners’ sexual needs and the necessity of support; partners are not certain about help-seeking.

The third study uses validated measures to quantitatively assess the mean change in patients’ and partners’ sexual function, sexual satisfaction, and dyadic satisfaction from before surgery to 18 months after surgery. In spite of the patients’ improving sexual function, patients’ as well as partners’ sexual satisfaction decreased. Female partners’ dyadic satisfaction appears to depend on the partner’s sexual satisfaction. In addition, the couple’s level of income has a moderating effect.

The three studies are independent in their research questions and methodologies but related in their exploratory nature and in their effort to examine different aspects of couples’ sexual recovery. The author integrates the findings from the three studies into existing research literature and proposes a conceptual model of couples’ sexual recovery after surgery for prostate cancer that can be tested with future research.