Treatment of testicular cancer: influence on pituitary-gonadal axis and sexual function.
OBJECTIVE
To investigate the influence of treatment for testicular cancer on the pituitary-gonadal axis and sexual function in long-time survivors after unilateral orchiectomy.


METHODS
Blood was drawn from patients treated for testicular cancer during routine oncologic follow-up for measurement of luteinizing hormone, follicle-stimulating hormone, sexual hormone-binding globulin, testosterone, and bioavailable testosterone. Sexual function was evaluated using the International Index of Erectile Function 15-item (IIEF-15) questionnaire. Patients were grouped according to treatment: group 1 followed a surveillance strategy, group 2 received two cycles of carboplatin monotherapy, and group 3 underwent cisplatin, etoposide, and bleomycin chemotherapy.


RESULTS
No statistically significant difference was found in the serum hormonal levels among the three groups, and all hormonal levels were within the 95% confidence range, except for follicle-stimulating hormone. The median serum testosterone level was 3.5 ng/mL in group 1, 3.9 ng/mL in group 2, and 4.2 ng/mL in group 3. In group 1, the median IIEF-15 score was 64.0, and the median Erectile Function (EF) domain score was 28. The median scores in groups 2 and 3 were 62.5 for IIEF-15 and 27.5 for EF and 65.0 for IIEF-15 and 30.0 for EF, respectively. No correlation was found between testosterone level and IIEF-15 or EF score.


CONCLUSIONS
None of the treatments investigated had a significant influence on the serum hormonal levels in long-time survivors of testicular cancer. Patients undergoing chemotherapy have no greater risk of developing a hormonal disorder than those following a surveillance strategy, and therapy for testicular cancer is not a risk factor for erectile dysfunction.
Lackner
Jakob
J
Department of Urology, Medical University of Vienna, Vienna, Austria. jakob.lackner@meduniwien.ac.at
Schatzl
Georg
G
Koller
Anke
A
Mazal
Peter
P
Waldhoer
Thomas
T
Marberger
Michael
M
Kratzik
Christian
C
D000328:Adult; D003075:Coitus; D006801:Humans; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy; D010902:Pituitary Gland / Q000502:physiology*; D013736:Testicular Neoplasms / Q000097:blood* / Q000601:surgery*; D013737:Testis / Q000502:physiology*; D013739:Testosterone / Q000097:blood*
D013739:Testosterone