title: Sexuality and body image in long-term survivors of testicular cancer.
abstract: OBJECTIVE
  This study explores sexual function and the influence of different treatment modalities on sexual function and body image among long-term survivors of testicular cancer (TCSs).
  
  
  METHODS
  A long-term follow-up assessment of all testicular cancer patients treated at Aarhus University Hospital, Denmark, from 1990 to 2000 was conducted. A total of 401 survivors (mean age: 46.6years; response rate: 66%) completed questionnaires concerning sexuality and changes in body image. Based on the treatment received, patients were categorised into one of four groups: surveillance, radiotherapy, chemotherapy, or chemotherapy supplemented with retroperitoneal lymph node dissection (RPLND).
  
  
  RESULTS
  Sexual dysfunctions were reported: 24% reduced sexual interest, 43% reduced sexual activity, 14% reduced sexual enjoyment, 18% erectile dysfunction, 7% ejaculatory problems and 3% increased sexual discomfort. Seventeen percent of the long-term TCSs reported changes in body image, and this was significantly associated with all six parameters of sexual dysfunction. When comparing treatments, only the RPLND procedure was associated with sexual dysfunction in the form of ejaculatory dysfunction.
  
  
  CONCLUSIONS
  Apart from RPLND, which was associated with ejaculatory dysfunction, treatment strategies for testicular cancer appeared not to influence sexual dysfunction. The level of erectile dysfunction seen in this sample of TCSs seemed to be higher than the level observed in the general male population and high levels of erectile dysfunction were associated with negative changes in body image. The results suggest that changes in body image are of importance when explaining the variation in sexual dysfunctions, but further prospective studies are needed to clarify this issue.
authors.affiliation: Department of Oncology, Aarhus University Hospital, Denmark. philross@rm.dk
authors.forename: P
authors.initials: P
authors.lastname: Rossen
authors.forename: A F
authors.initials: AF
authors.lastname: Pedersen
authors.forename: R
authors.initials: R
authors.lastname: Zachariae
authors.forename: H
authors.initials: H
authors.lastname: von der Maase
mesh_terms: D000328:Adult; D000367:Age Factors; D001828:Body Image; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology* / Q000534:rehabilitation; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology; D019529:Sexuality / Q000502:physiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data; D013736:Testicular Neoplasms / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology* / Q000534:rehabilitation