title: Health-related quality of life, depression, and sexual function in testicular cancer survivors in a developing country: a Serbian experience.
abstract: OBJECTIVE
  The aims of this study were to assess health-related quality of life (HRQoL), depression, adverse physical symptoms, and sexual function within Serbian long-term testicular cancer survivors (TCS) and to address cultural specificity.
  
  
  METHODS
  This is a cross-sectional study involving 202 TCS, followed up after platinum-based chemotherapy. The HRQoL was measured using the Short Form 36 and the European Organization for Research and Treatment of Cancer Quality of Life questionnaire. The Beck Depression Inventory (BDI) was used to explore general depressive status while sexual function was assessed using a nine-item questionnaire.
  
  
  RESULTS
  The mean follow-up time since treatment was 47.3 ± 26.8 months. The highest values of the SF-36 scales were obtained for physical functioning, and the lowest SF-36 values were obtained for vitality. Age of patients and BDI scores statistically significantly influenced total quality of life. The mean score of the whole sample on the BDI-II was 4.0. Age is the only statistically significant risk factor for the development of depression. A total of 27.3% TCS reported decreased sexual function compared to the period before treatment. Any level of impairment of erectile function was reported by 20.8% patients and problems with ejaculation by 25.7% patients. Loss of desire was reported by 17.3% TCS. The presence of sexual problems statistically significantly lowered scores of SF-36 domains.
  
  
  CONCLUSIONS
  Sexual problems seriously impaired HRQoL in TCS. Additionally, HRQoL was also affected by age, depression, and fatigue. Serbian TCS achieved high levels of SF-36 scores, and these results are comparable to studies conducted in developed countries.
authors.affiliation: Clinic of Urology, Clinical Center of Serbia, Belgrade, Serbia. urosbu@gmail.com
authors.forename: Uros
authors.initials: U
authors.lastname: Bumbasirevic
authors.forename: Nebojsa
authors.initials: N
authors.lastname: Bojanic
authors.forename: Tatjana
authors.initials: T
authors.lastname: Pekmezovic
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Janjic
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Janicic
authors.forename: Bogomir
authors.initials: B
authors.lastname: Milojevic
authors.forename: Cane
authors.initials: C
authors.lastname: Tulic
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D003906:Developing Countries; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D055771:Serbia / Q000453:epidemiology; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D017741:Survivors; D013736:Testicular Neoplasms / Q000473:pathology* / Q000523:psychology / Q000628:therapy; D055815:Young Adult
chemical_list: D002945:Cisplatin