Sarah Azari, MD, on early sexual health education for women with bladder cancer

In this interview, Sarah Azari, MD, discusses the background and rationale for a prospective study examining the impact of perioperative education on demoralization and sexual function in women with bladder cancer.¹ These results were shared during the Society of Women in Urology (SWIU) 15th Annual Clinical Mentoring Conference in Nashville, Tennessee.

Azari is a urologic oncology fellow at the University of California, San Diego.

By way of background, Azari explained that retrospective data consistently show women with bladder cancer experience higher rates of depression, demoralization, and sexual dysfunction, while also reporting less counseling on these issues compared with men. Despite this, there has been a lack of prospective interventions aimed at improving quality of life and survivorship outcomes in this population, prompting the development of a structured educational approach delivered around the time of surgery.

In total, the study enrolled 21 female patients with bladder cancer at Johns Hopkins University. Participants were randomly assigned to receive standard care (n = 10) or additional education (n = 11).

Overall, findings from the pilot trial showed that perioperative education was associated with improved demoralization rates. In the education cohort, scores on the Demoralization Scale-II decreased from 6.9 ± 6.0 at baseline to 2.6 ± 2.5 at 1 year, vs remaining stable in the standard care cohort, with scores of 4.8 ± 4.3 at baseline and 4.8 ± 5.3 at 1 year.

Importantly, qualitative analysis revealed wide variability in patient priorities: while many women valued discussions about sexual function, others preferred to focus primarily on cancer treatment. Azari underscores that these insights reinforce the need for patient-centered, individualized interventions that align care with each woman’s goals and stage in her cancer journey.

REFERENCE

1. Azari S. McNamara M, Covington R, et al. Impact of perioperative education on demoralization and sexual function in women with bladder cancer: A mixed methods randomized pilot trial. Society of Women in Urology (SWIU) 15th Annual Clinical Mentoring Conference. Nashville, Tennessee. January 30-31, 2026