Sexual function in men treated for testicular cancer.
BACKGROUND
Testicular germ cell cancer (TGCC) patients may be at risk of developing sexual dysfunction after treatment.


OBJECTIVE
The aim of this study was to assess the prevalence of sexual dysfunctions in TGCC patients 3 to 5 years after treatment, and relate findings to biochemical hypogonadism, treatment intensity, and the expected prevalence in the Swedish male population.


METHODS
A questionnaire study on 129 consecutive TGCC patients 3 to 5 years post-treatment was performed. Comparators were an age-matched nationally representative group of men (N = 916) included in a study on sexual life in Sweden.


METHODS
Sexual functions (including erectile dysfunctional distress), time since last intercourse, sexual satisfaction, and experience of sexological treatment seeking were assessed using the same questions used in the epidemiological study on sexual life in Sweden. The findings in TGCC patients were correlated to biochemical signs of hypogonadism and type of oncological treatment: Surveillance, adjuvant chemotherapy, adjuvant radiotherapy, or standard doses of chemotherapy.


RESULTS
A higher proportion of TGCC patients than comparators were likely to report low sexual desire (odds ratio [OR] 6.7 [95% confidence interval {CI} 2.1-21]) as well as erectile dysfunction (OR 3.8 [95% CI 1.4-10]). No significant differences were observed regarding erectile dysfunctional distress, change of desire over time, interest in sex, premature or delayed ejaculation, time since last intercourse, need for or receiving sexual advice, or sexual satisfaction. Hypogonadism did not predict erectile dysfunction (OR 1.1 [95% CI 0.26-4.5]) or low sexual desire (OR 1.2 [95% CI 0.11-14]). Treatment modality had no obvious impact on sexual function.


CONCLUSIONS
Men treated for testicular cancer had higher risk of having low sexual desire and erectile dysfunction 3 to 5 years after completion of therapy than comparators. These sexual dysfunctions were not significantly associated with treatment intensity or hypogonadism.
Eberhard
Jakob
J
Department of Oncology, Lund University Hospital, Lund, Sweden. jakob.eberhard@med.lu.se
Ståhl
Olof
O
Cohn-Cedermark
Gabriella
G
Cavallin-Ståhl
Eva
E
Giwercman
Yvonne
Y
Rylander
Lars
L
Eberhard-Gran
Malin
M
Kvist
Ulrik
U
Fugl-Meyer
Kerstin S
KS
Giwercman
Aleksander
A
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D016001:Confidence Intervals; D006801:Humans; D007006:Hypogonadism / Q000139:chemically induced / Q000150:complications* / Q000209:etiology; D018783:Impotence, Vasculogenic / Q000139:chemically induced* / Q000453:epidemiology / Q000209:etiology; D007989:Libido / Q000187:drug effects*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000150:complications / Q000188:drug therapy*; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D013736:Testicular Neoplasms / Q000150:complications / Q000188:drug therapy*; D013997:Time Factors
D000970:Antineoplastic Agents