Sexual concerns after prostate cancer (PCa) treatment are high. Flexible coping is a crucial element to maintaining sexual activity after PCa and improves adaptation outcomes. We aimed to identify potential sexual adaptation styles reported by men following PCa treatment, and to assess relationships among associated variables and outcomes. Individuals (n = 223) with PCa treatment history (e.g., radical prostatectomy [n = 165, 74.0%], external beam radiation [n = 83, 37.2%], hormone/androgen deprivation therapy [n = 83, 37.2%]), completed an online survey assessing sexual variables and processes of sexual adaptation. Using a combination of inductive and deductive coding, open-ended responses were thematically analyzed and grouped into sexual adaptation styles. Factors potentially associated with sexual adaptation styles (e.g., age, perceived partner involvement, co-morbidities, relationship duration, time since PCa treatment, desire for physical affection, depression, relationship adjustment) were tested using multinomial logistic regression. Outcomes of sexual well-being (sexual distress, sexual bother, sexual satisfaction) and relationship adjustment were compared against each sexual adaptation style using a multivariate analysis of variance. Sexual activity status and satisfaction with the adaptation process was assessed across the sexual adaptation styles using a chi-square analysis and post-hoc tests. Two distinct categories were identified: those who had Adapted (n = 185) and those who had Not Adapted (n = 38). Four sexual adaptation styles emerged in the adapted category: Relationship Renegotiation (n = 53) and Sexual Renegotiation (n = 47), which were couples-focused styles, and Acceptance/Resignation (n = 34) and Masturbation/Erection (n = 48), which were individual-focused styles. Participants who could not be categorized as one style, but rather met several, were identified as Mixed (n = 3). Higher rates of depression, lower relationship adjustment, lack of sexual activity, and greater dissatisfaction with the adaptation process were observed for Not Adapted participants. Participants engaged in any type of adaptation style fared better than those who had Not Adapted. Couples-focused styles tended to emphasize renegotiation, including a changed perspective on the expression of the relationship. Perceived direct engagement of the partner facilitated adaptation and emphasized engagement with flexible coping, either through redefining priorities or ways of being sexual. Individual-focused styles emphasized pre-cancer erectile function, and either aimed to return to capacity for penetrative sexual activity or accepted its inaccessibility and largely an abandonment of partnered sexual activity.

前列腺癌（PCa）治疗后对性的担忧很高。灵活的应对方式是前列腺癌后维持性活动并改善适应结果的关键因素。我们的目的是确定前列腺癌治疗后男性报告的潜在性适应方式，并评估相关变量和结果之间的关系。 有 PCa 治疗史的个体 ( n = 223)（例如，根治性前列腺切除术 [ n  = 165, 74.0%]、外照射 [ n  = 83, 37.2%]、激素/雄激素剥夺疗法 [ n  = 83, 37.2%]） ，完成了一项评估性变量和性适应过程的在线调查。使用归纳和演绎编码的组合，对开放式反应进行主题分析并分为性适应风格。使用多项逻辑回归测试可能与性适应方式相关的因素（例如，年龄、感知到的伴侣参与、合并症、关系持续时间、自PCa治疗以来的时间、对身体爱的渴望、抑郁、关系调整）。使用多变量方差分析，将性幸福的结果（性困扰、性困扰、性满意度）和关系调整与每种性适应方式进行比较。使用卡方分析和事后检验来评估不同性适应方式的性活动状态和对适应过程的满意度。确定了两个不同的类别：已适应的人 ( n  = 185) 和未适应的人 ( n  = 38)。适应类别中出现了四种性适应风格：关系重新谈判（n  = 53）和性重新谈判（n  = 47），这是以夫妻为中心的风格，以及接受/放弃（n  = 34）和自慰/勃起（n  = 48） ），这是以个人为中心的风格。无法归类为一种风格而是遇到多种风格的参与者被确定为混合（n = 3）。未适应的参与者的抑郁率较高、关系调整较低、缺乏性活动以及对适应过程的更大不满。参与任何类型的适应方式的参与者都比那些没有适应的人表现得更好。以夫妻为中心的风格倾向于强调重新谈判，包括改变表达关系的观点。感知到伴侣的直接参与促进了适应，并强调了灵活应对的参与，无论是通过重新定义优先事项还是性方式。以个人为中心的风格强调癌前的勃起功能，要么旨在恢复插入性性活动的能力，要么接受其难以接近并在很大程度上放弃伴侣性活动。