ArticleWorld journal of urology2026
The training paradox in oncosexuality: a multinational survey on clinician attitudes, barriers, and sexual health communication in geriatric prostate cancer care.
Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeSexual dysfunction is common after prostate radiotherapy, yet communication barriers remain unclear. This multinational study assessed radiation oncologists' practices, attitudes, and sexual-health training. MATERIALS AND
methodsThe International Geriatric Radiotherapy Group (IGRG) disseminated a 38-item cross-sectional survey to radiation oncologists across 17 countries. The instrument captured demographics, discussion frequencies, perceived barriers, referral patterns, and attitudes toward oncosexuality. Data was analyzed with descriptive statistics, chi-square tests, and multivariable logistic regression. An exploratory sensitivity analysis restricted to respondents reporting regular management of patients receiving radiotherapy with potential impact on sexual health (≥ 1 such patient per month) was performed.
resultsAmong 117 radiation oncologists, 87% (102/117) reported some clinical exposure to patients receiving radiotherapy with potential impact on sexual health, and 57% (67/117) reported regular exposure (≥ 1 patient per month). 48% reported that patients rarely initiated discussions, and 8% never addressed the topic. Main barriers were time (39%), competing oncologic priorities (35%), and embarrassment (26%); 60% felt discomfort with older patients. Multivariable analysis revealed a "training paradox": clinicians with formal sexual-health training (56%) had significantly lower odds of initiating discussions at the first visit (OR 0.37, 95% CI 0.15-0.94, p = 0.037) and higher odds of embarrassment with older patients (OR 5.72, 95% CI 2.09-15.65, p = 0.001), independent of age, gender, experience, and practice setting.
conclusionThese findings suggest that awareness-focused sexual-health training alone may be insufficient; behaviourally anchored communication training and formal referral pathways are needed.
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