title: Sexual function, depressive symptoms and marital status in nonseminoma testicular cancer patients: a longitudinal study.
abstract: OBJECTIVE
  To longitudinally investigate sexual functioning in testicular cancer patients during the first year, and examine the effect of relationship status (with a partner or single) and depressive symptoms on sexual functioning.
  
  
  METHODS
  93 testicular cancer patients (39% single) treated in two large referral centers for testicular cancer filled in the International Index of Erectile Function (IIEF) and CES-D after orchiectomy (T1) and 3 (T2) and 12 (T3) months later.
  
  
  RESULTS
  Orgasmic functioning, overall satisfaction and total sexual functioning decreased between T1 and T2 and increased to an above T1 level at T3. Levels of erectile functioning and intercourse satisfaction were higher at T3 than at T1 and T2. Desire remained stable. Type of treatment did not affect sexual functioning. Singles reported worse sexual functioning at all measurement times than committed patients, and comparable desire. One year after surgery, singles also reported worse sexual functioning on three domains when compared with norms. Depressive symptoms were highest and significantly but weakly related to one domain of sexual functioning at T1, to three domains at T2, and to none at T3. Early depressive symptoms had small to moderate predictive power on sexual functioning at T2, but not at T3.
  
  
  CONCLUSIONS
  Sexual functioning, but not desire, fluctuates during the first year after testicular cancer. Type of treatment and depressive symptoms were no risk factors for sexual dysfunction in the longer term. Singles reported more sexual problems than patients in a relationship and norms, they may need more information and guidance concerning their sexuality.
authors.affiliation: Department of Surgical Oncology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Marrit A
authors.initials: MA
authors.lastname: Tuinman
authors.forename: Harald J
authors.initials: HJ
authors.lastname: Hoekstra
authors.forename: Damon J
authors.initials: DJ
authors.lastname: Vidrine
authors.forename: Ellen R
authors.initials: ER
authors.lastname: Gritz
authors.forename: Dirk Th
authors.initials: DT
authors.lastname: Sleijfer
authors.forename: Joke
authors.initials: J
authors.lastname: Fleer
authors.forename: Josette E H M
authors.initials: JE
authors.lastname: Hoekstra-Weebers