EAU Webinar: The Patient and Partner Perspectives on the Impact of Female Cystectomy, Penile Cancer and Prostate Cancer on Sexual Function
Radical surgery for urological cancers can deeply affect intimacy and relationships. A recent EAU Patient Office webinar brought together patients and caregivers to share experiences and highlight the need for better support.
Introduction
The EAU Patient Office recently organised a webinar on the 15th of July 2025 to explore the effect that radical surgical treatment for penile, prostate and bladder cancer has on sexual function and intimacy from the patient and partner perspective. The faculty consisted of moderator Rob Cornes, Male Cancer Information Nurse Specialist and Chair of the ORCHID Patient Advocacy Group and patient advocates; Mr John Osborne (penile cancer survivor and Chair of the Penile Cancer Patient Advocacy Group at ERN eUROGEN ), Mr Paul Campbell (prostate cancer survivor and Founder of Cancer Black Care, a UK-based charity) and Miss Susan Richardson (a bladder cancer patient advocate supported by Fight Bladder Cancer UK and the World Bladder Cancer Patient Coalition. ). In addition, Mrs Jaqueline Daly (patient care giver and advocate and Director at East Galway & Midlands cancer support) provided insight of caring for her husband following radical prostatectomy.
Background
The impact that radical surgical treatment may have on an individual’s body image and sexual intimacy can be devastating at a physical, psychological and psychosocial level, with many patients never regaining the physical or emotional confidence that their relationships enjoyed prior to treatment. The impact of treatment will also inevitably affect partners, who will also share the burden of these changes.
Supporting individuals in this situation is often difficult; the full impact of treatment on sexual function and intimacy may take many months to be fully realised, while supportive information given at the time of diagnosis will often feel overwhelming.
Discussion
Following discussion, the faculty agreed that a simple strategy of signposting to third sector organisations and peer support, which could be initiated by any healthcare professional at the point of diagnosis, may significantly improve the patient journey outside of the clinical setting. In addition, follow-up appointments 3–6 months after treatment, when the consequences of treatment on sexual function and intimacy are more fully realised, offer an ideal opportunity to explore the need for psychological support.
‘We were almost like strangers, putting on smiles.’
‘I'm not actually sure if I have completely adjusted or we have completely adjusted. The thing that really surprised me was the way in which it questioned, what I felt of myself as a man.’
‘It was easier at first because I was single, so there was no pressure to perform, to have sex, etc. And I didn't have to explain anything to anyone. And I guess during that time again, I was kind of building my relationship with my body, how my body functioned, the weight loss, the scars, etc. But then once in a relationship, it became harder to face intimacy because it felt different. And I guess subconsciously, I avoided it.’
Supporting individuals in this situation is often difficult; the full impact of treatment on sexual function and intimacy may take many months to be fully realised, while supportive information given at the time of diagnosis will often feel overwhelming.
‘I couldn’t even think about life after treatment. The diagnosis and medical language were overwhelming. I was just trying to survive.’
In addition, healthcare professionals often have inadequate time or resources to provide comprehensive support or may feel unqualified to do so, especially if they have little experience of a particular disease area.
After talking through their own experiences in often frank, and intimate detail, it became clear that despite being treated for different cancers, there were common unmet needs experienced by each of the faculty members. These centred around a lack of signposting to supportive information, peer and psychological support.
Signposting patients to disease-specific charities helps them connect with people who understand their challenges and can offer support outside the clinic.
‘I just wanted to have known that somebody was there. I wanted like a business card or someone to call without having to research it or do it myself. There was no signposting or nothing given to me whatsoever regarding any future help.’
Signposting to peer support groups can provide a forum for learning from those who have already been treated. Practical advice from peers and their partners can significantly reduce the challenges a patient may face in adapting to long term side effects, while speaking to someone who has been through the same experience can radically improve a patient’s psychological and psychosocial outlook.
Many healthcare professionals will have little experience with psychological support, or where to signpost patients to, but making patients and their partners aware that psychological and/or psychosexual counselling, will help them adjust to altered body image and adapt to sexual intimacy, dramatically improving their quality of life.
‘I was not offered any sort of counselling or psychological support at the beginning. I think it should be offered because it would have been extremely helpful if offered at the right time by the right people.’
‘It needs to be offered over and over again because, we're not all the same. One size does not fit all. So, it needs to be individualised. And I think that for health professionals, always be mindful of somebody's mental health, patient and the partner.’
‘I was offered it right after I was diagnosed in the same room within 3 to 4 minutes. I had no time to process anything and it was kind of being forced on me. But that was the only time it was offered throughout the journey. I think that that should have been something that was offered throughout the journey and not just once. And I think I should have been signposted to peer support groups.’