{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:06:48Z","timestamp":1792786008367,"version":"4.5.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T00:00:00Z","timestamp":1710460800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Johns Hopkins Greenberg Bladder Cancer Institute Research Fund","award":["P0536952"],"award-info":[{"award-number":["P0536952"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Women\u2019s sexual health after radical cystectomy is an important but poorly understood aspect of bladder cancer survivorship. Dedicated investigation is needed to elucidate patient perceptions on sexual function and dysfunction in this setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>In this study we sought to qualitatively examine women\u2019s perceptions and experiences of sexual health following radical cystectomy for bladder cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted one-on-one qualitative telephone interviews with 40 women who underwent radical cystectomy in the past 6\u00a0months to 5 years and signed a research consent form to be contacted for future studies. We examined women\u2019s experiences of engaging in sexual activity after surgery and their attitudes toward sex and body image. We audio recorded, transcribed, and coded the interviews using ATLAS.ti software and applied grounded theory methods for analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>For data that emerged during the qualitative interviews that was related to lack of knowledge about how physical and psychological sexual health would be affected after surgery, we reviewed and discussed transcripts that enabled coding of the data into emerging topic areas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our analysis yielded 4 main themes. (1) Women reported receiving little to no information from providers about female sexual dysfunction prior to or after radical cystectomy. Women wished they had been provided more information about female sexual dysfunction from their clinicians, including strategies for postoperative self-pleasure and nonintercourse methods of sexual pleasure with partners. (2) Women shared that they were not sexually active following surgery due to physical and mental barriers. (3) When women did try to engage in sex, they described feeling disappointed that it did not feel the same as prior to surgery. (4) Some women found that physical therapy helped them to physically and mentally recover their strength to engage in sexual activity again.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Implications<\/jats:title>\n                    <jats:p>Clinicians must directly address sexual health concerns with patients who undergo radical cystectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Strengths and Limitations<\/jats:title>\n                    <jats:p>This study has several key strengths. Investigation into women\u2019s sexual function and dysfunction addresses a gap in understanding of this component of women\u2019s health-related quality of life after radical cystectomy, which represents an unmet need. The large number of interviews conducted as well as the in-depth information obtained through one-on-one interviews are additional strengths. This study also has limitations, including possible shortcomings of telephone interviews compared with in-person interviews. However, telephone interviews were beneficial because the interviews took place during the COVID-19 pandemic and spared patients from extra visits or from having to travel long distances to the respective medical centers. Other possible limitations were that patients may have been reluctant to share all of their experiences and that patients who underwent urostomies, also termed ileal conduits, were overrepresented in this study compared with women who underwent continent urine diversions, which allow greater control over urine output.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Broadening the understanding of sexual health beyond sexual intercourse to encompass sexuality and self-pleasure can provide clinicians, patients, and their families with more effective preparation and strategies to care for an essential aspect of their wellbeing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jsxmed\/qdae025","type":"journal-article","created":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T17:10:33Z","timestamp":1708449033000},"page":"464-470","source":"Crossref","is-referenced-by-count":13,"title":["\u201cI think my vagina is still there?\u201d: Women\u2019s perspectives on sexual function and dysfunction following radical cystectomy for bladder cancer, a qualitative study"],"prefix":"10.1093","volume":"21","author":[{"given":"Rachel Carmen","family":"Ceasar","sequence":"first","affiliation":[{"name":"Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine , 1845 N Soto St, Los Angeles, CA 90032 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyedeh-Sanam","family":"Ladi-Seyedian","sequence":"additional","affiliation":[{"name":"Department of Urology , Norris Comprehensive Cancer Center, , 1441 Eastlake Ave, Los Angeles, CA 90033 , United States"},{"name":"University of Southern California , Norris Comprehensive Cancer Center, , 1441 Eastlake Ave, Los Angeles, CA 90033 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenique","family":"Escobar","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, San Francisco , 400 Parnassus Ave, San Francisco, CA 94143 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jullet","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Urology , Norris Comprehensive Cancer Center, , 1441 Eastlake Ave, Los Angeles, CA 90033 , United States"},{"name":"University of Southern California , Norris Comprehensive Cancer Center, , 1441 Eastlake Ave, Los Angeles, CA 90033 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kailyn","family":"Koh","sequence":"additional","affiliation":[{"name":"Department of Urology , Norris Comprehensive Cancer Center, , 1441 Eastlake Ave, Los Angeles, CA 90033 , United States"},{"name":"University of Southern California , Norris Comprehensive Cancer Center, , 1441 Eastlake Ave, Los Angeles, CA 90033 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sima","family":"Porten","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, San Francisco , 400 Parnassus Ave, San Francisco, CA 94143 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carissa","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, San Francisco , 400 Parnassus Ave, San Francisco, CA 94143 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin E","family":"Gould","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine , 1845 N Soto St, Los Angeles, CA 90032 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumeet","family":"Bhanvadia","sequence":"additional","affiliation":[{"name":"Department of Urology , Norris Comprehensive Cancer Center, , 1441 Eastlake Ave, Los Angeles, CA 90033 , United States"},{"name":"University of Southern California , Norris Comprehensive Cancer Center, , 1441 Eastlake Ave, Los Angeles, CA 90033 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,3,15]]},"reference":[{"issue":"2","key":"2024050206210798500_ref1","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.eururo.2015.08.037","article-title":"Gender and bladder cancer: a collaborative review of etiology, biology, and outcomes","volume":"69","author":"Dobruch","year":"2016","journal-title":"Eur Urol"},{"issue":"4","key":"2024050206210798500_ref2","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1002\/cncr.28416","article-title":"Sex disparities in diagnosis of bladder cancer after initial presentation with hematuria: a nationwide claims-based investigation","volume":"120","author":"Cohn","year":"2014","journal-title":"Cancer"},{"issue":"5","key":"2024050206210798500_ref3","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1016\/j.eururo.2013.11.040","article-title":"Gender-specific differences in clinicopathologic outcomes following radical cystectomy: an international multi-institutional study of more than 8000 patients","volume":"66","author":"Luth","year":"2014","journal-title":"Eur Urol"},{"issue":"4","key":"2024050206210798500_ref4","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1016\/j.urology.2013.10.060","article-title":"Female gender is associated with a worse survival after radical cystectomy for urothelial carcinoma of the bladder: a competing risk analysis","volume":"83","author":"MJC","year":"2014","journal-title":"Urology"},{"issue":"22","key":"2024050206210798500_ref5","doi-asserted-by":"crossref","first-page":"5235","DOI":"10.1002\/cncr.25310","article-title":"Delays in diagnosis and bladder cancer mortality","volume":"116","author":"Hollenbeck","year":"2010","journal-title":"Cancer"},{"issue":"9","key":"2024050206210798500_ref6","doi-asserted-by":"crossref","first-page":"3004","DOI":"10.1002\/cam4.3835","article-title":"Disparities in male versus female oncologic outcomes following bladder preservation: a population-based cohort study","volume":"10","author":"Ballas","year":"2021","journal-title":"Cancer Med"},{"issue":"1","key":"2024050206210798500_ref7","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1186\/s12905-018-0602-4","article-title":"Predictors of female sexual dysfunction: a systematic review and qualitative analysis through gender inequality paradigms","volume":"18","author":"McCool-myers","year":"2018","journal-title":"BMC Womens Health"},{"issue":"5","key":"2024050206210798500_ref8","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1016\/j.fertnstert.2007.09.012","article-title":"Female sexual dysfunction: classification, pathophysiology, and management","volume":"88","author":"Raina","year":"2007","journal-title":"Fertil Steril"},{"issue":"6","key":"2024050206210798500_ref9","doi-asserted-by":"crossref","DOI":"10.1016\/S0022-5347(01)66688-6","article-title":"Rationale and technique of nerve sparing radical cystectomy before an orthotopic neobladder procedure in women","volume":"154","author":"Stenzl","year":"1995","journal-title":"J Urol"},{"issue":"3","key":"2024050206210798500_ref10","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/S0015-0282(02)04695-2","article-title":"Seeking help for sexual function complaints: what gynecologists need to know about the female patient's experience","volume":"79","author":"Berman","year":"2003","journal-title":"Fertil Steril"},{"issue":"3","key":"2024050206210798500_ref11","article-title":"Surgical factors associated with male and female sexual dysfunction after radical cystectomy: what do we know and how can we improve outcomes?","volume":"6","author":"Pederzoli","year":"2018","journal-title":"Sex Med Rev."},{"issue":"6","key":"2024050206210798500_ref12","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1001\/jama.281.6.537","article-title":"Sexual dysfunction in the United States: prevalence and predictors","volume":"281","author":"Laumann","year":"1999","journal-title":"JAMA"},{"issue":"6","key":"2024050206210798500_ref13","doi-asserted-by":"crossref","first-page":"463","DOI":"10.3109\/21681805.2015.1055589","article-title":"Evaluating sexual function in women after radical cystectomy as treatment for bladder cancer","volume":"49","author":"Booth","year":"2015","journal-title":"Scand J Urol"},{"issue":"6","key":"2024050206210798500_ref14","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1080\/13697137.2016.1225714","article-title":"Female sexual dysfunction post radical cystectomy and urinary diversion","volume":"19","author":"Zahran","year":"2016","journal-title":"Climacteric."},{"issue":"8","key":"2024050206210798500_ref15","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1111\/j.1464-410X.2004.04796.x","article-title":"Women's sexual dysfunction: a pathophysiological review","volume":"93","author":"Salonia","year":"2004","journal-title":"BJU Int"},{"issue":"12","key":"2024050206210798500_ref16","doi-asserted-by":"crossref","first-page":"2518","DOI":"10.1016\/j.jsxm.2020.08.022","article-title":"Results of a World Health Organization scoping of sexual dysfunction-related guidelines: what exists and what is needed","volume":"17","author":"Gonsalves","year":"2020","journal-title":"J Sex Med"},{"issue":"12","key":"2024050206210798500_ref17","article-title":"Bladder cancer survivorship","volume":"19","author":"BSK","year":"2018","journal-title":"Curr Urol Rep"},{"issue":"4","key":"2024050206210798500_ref18","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1111\/bju.14047","article-title":"Impact of bladder cancer on health-related quality of life","volume":"121","author":"Smith","year":"2018","journal-title":"BJU Int"},{"issue":"1-6","key":"2024050206210798500_ref19","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1080\/21681805.2022.2157872","article-title":"Women's experience of sexuality after radical cystectomy \u2013 a qualitative study","volume":"57","author":"L\u00f6fgren","year":"2023","journal-title":"Scand J Urol"},{"key":"2024050206210798500_ref20","article-title":"Urinary function in female patients after traditional, organ-sparing and nerve-sparing radical cystectomy for bladder cancer: a systematic review and pooled analysis","author":"Laukhtina","year":"2023","journal-title":"BJU Int"},{"key":"2024050206210798500_ref21","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.urology.2020.08.018","article-title":"Understanding psychosocial and sexual health concerns among women with bladder cancer undergoing radical cystectomy","volume":"151","author":"Gupta","year":"2021","journal-title":"Urology"},{"issue":"Suppl","key":"2024050206210798500_ref22","first-page":"4","article-title":"Quality of life research within the EORTC-the EORTC QLQ-C30. European Organisation for Research and Treatment of Cancer","volume":"38","author":"Fayers","year":"2002","journal-title":"Eur J Cancer"},{"key":"2024050206210798500_ref23","volume-title":"Constructing Grounded Theory: A Practical Guide through Qualitative Analysis","author":"Charmaz","year":"2006"},{"issue":"3","key":"2024050206210798500_ref24","first-page":"1","article-title":"The power and potential of grounded theory","volume":"6","author":"Charmaz","year":"2012","journal-title":"Med Sociol."},{"key":"2024050206210798500_ref25","doi-asserted-by":"crossref","first-page":"205031211882292","DOI":"10.1177\/2050312118822927","article-title":"Grounded theory research: a design framework for novice researchers","volume":"7","author":"Chun Tie","year":"2019  2","journal-title":"SAGE Open Med"},{"issue":"12","key":"2024050206210798500_ref26","doi-asserted-by":"crossref","first-page":"531.e7","DOI":"10.1016\/j.urolonc.2016.06.010","article-title":"Unmet informational and supportive care needs of patients following cystectomy for bladder cancer based on age, sex, and treatment choices","volume":"34","author":"Mohamed","year":"2016","journal-title":"Urol Oncol"},{"issue":"4","key":"2024050206210798500_ref27","doi-asserted-by":"crossref","first-page":"177","DOI":"10.5737\/1181912x204177181","article-title":"Radical cystectomy for bladder cancer: a qualitative study of patient experiences and implications for practice","volume":"20","author":"Fitch","year":"2010","journal-title":"Can Oncol Nurs J."},{"issue":"1","key":"2024050206210798500_ref28","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1002\/bco2.186","article-title":"Female sexual function in bladder cancer: a review of the evidence","volume":"4","author":"Martin","year":"2023","journal-title":"BJUI Compass"},{"key":"2024050206210798500_ref29","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.urology.2021.06.012","article-title":"What women want: radical cystectomy and perioperative sexual function educational needs","volume":"157","author":"Westerman","year":"2021","journal-title":"Urology"}],"container-title":["The Journal of Sexual Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/21\/5\/464\/57359388\/qdae025.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/21\/5\/464\/57359388\/qdae025.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T02:21:26Z","timestamp":1714616486000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jsm\/article\/21\/5\/464\/7630114"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,15]]},"references-count":29,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,3,15]]},"published-print":{"date-parts":[[2024,4,30]]}},"URL":"https:\/\/doi.org\/10.1093\/jsxmed\/qdae025","relation":{},"ISSN":["1743-6095","1743-6109"],"issn-type":[{"value":"1743-6095","type":"print"},{"value":"1743-6109","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,5]]},"published":{"date-parts":[[2024,3,15]]}}}