title: Sexual problems after total or partial laryngectomy.
abstract: OBJECTIVE
  To investigate sexual problems that can occur after laryngeal and hypopharyngeal cancer surgery and to specify possible influencing factors.
  
  
  METHODS
  Multi-institutional cross-sectional study.
  
  
  METHODS
  Two hundred six patients were interviewed in person using the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire, Head and Neck Module (EORTC QLQ-H&N35), the Hospital Anxiety and Depression Scale, and a structured interview assessing alcohol and tobacco consumption, sociodemographic data, and specific sexual problems. Type of surgery, tumor site, and tumor stage were documented according to the participants' medical records. Multivariate analysis of variance was used to assess the independent impact of each factor.
  
  
  RESULTS
  More than half of the patients in our study reported having reduced libido and sexual enjoyment after treatment. Sixty percent considered it an important issue for their contentment with life. Sexual difficulties were found to be unrelated with gender, formal education, alcohol and tobacco consumption, type of surgery (partial vs. total laryngectomy), radiotherapy, and tumor site. Psychological distress (F = 46.27, P < .001) was seen to have a strong independent impact on the occurrence of sexual difficulties and stage of disease (F = 4.50, P < .05) and age (F = 4.79, P < .05), a moderate independent impact.
  
  
  CONCLUSIONS
  Reduced libido and sexual enjoyment is a common problem after laryngeal and hypopharyngeal cancer surgery. However, it is not caused by the oncological treatment but rather by the cancer itself. Depression is often associated with sexual problems. Both should be discussed in medical consultations with head and neck cancer patients when appropriate to provide adequate treatment.
authors.affiliation: Department of Social Medicine, University of Leipzig, Leipzig, Germany. susanne.singer@medizin.uni-leipzig.de
authors.forename: Susanne
authors.initials: S
authors.lastname: Singer
authors.forename: Helge
authors.initials: H
authors.lastname: Danker
authors.forename: Andreas
authors.initials: A
authors.lastname: Dietz
authors.forename: Ulrike
authors.initials: U
authors.lastname: Kienast
authors.forename: Friedemann
authors.initials: F
authors.lastname: Pabst
authors.forename: Eberhard F
authors.initials: EF
authors.lastname: Meister
authors.forename: Jens
authors.initials: J
authors.lastname: Oeken
authors.forename: Alexander
authors.initials: A
authors.lastname: Thiele
authors.forename: Reinhold
authors.initials: R
authors.lastname: Schwarz
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D007172:Erectile Dysfunction / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D007825:Laryngectomy / Q000523:psychology*; D007989:Libido; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000523:psychology; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012307:Risk Factors; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis / Q000523:psychology*; D020018:Sexual Dysfunctions, Psychological / Q000175:diagnosis / Q000523:psychology*; D012803:Sick Role; D011795:Surveys and Questionnaires; D014140:Tracheotomy / Q000523:psychology