title: Sexual outcomes after organ potency-sparing surgery and glans reconstruction in patients with penile carcinoma.
abstract: BACKGROUND
  Radical surgery is the "gold standard" for treatment of invasive penile carcinoma but very poor aesthetic, functional and psychological outcomes have been reported. Our purpose was to assess the impact of organ potency-sparing surgery in locally confined carcinoma of the penis.
  
  
  METHODS
  We evaluated retrospectively 42 patients with early penile cancer (Ta,T1,T2), treated with glandulectomy and glanduloplasty with urethral mucosa and sparing of cavernosal apexes, or glandulectomy and limited apical resection in cases of Stage T2. Sexual function, ejaculation and libido were evaluated with an IIEF-15 questionnaire before the appearance of neoplasia (about three months before the surgery) and six months after surgery. Quality of life was evaluated by the Bigelow-Young questionnaire. The scores relating to two weeks prior to the surgery have been compared to those obtained six months after surgery. The statistical analysis was conducted using t-Student for repeated measures and analysis of variance.
  
  
  RESULTS
  Six months after surgery 73% of patients reported spontaneous rigid erections, 60% coital activity while 76% of the group treated with urethral glanduloplasty reported normal ejaculation and orgasm, regained an average of 35 days after surgery. The average IIEF-15 scores reported in the entire series in the domains of erection, libido and coital activity of the pre-cancer period were not statistically different than those recorded six months after surgery. In the group treated with glandular reconstruction, pre-and postoperative IIEF-15 mean scores related to ejaculation and orgasm domains were not significantly different. Mean scores of Bigelow-Young questionnaires related to sexual pleasure, familial, social and professional relationships showed significant improvement after surgery.
  
  
  CONCLUSIONS
  Potency sparing-sparing surgical treatments have a positive impact on a wide spectrum of the patient's life including family relationships, and social and working conditions.
authors: Department of Urology, Catholic University of Rome, Italy.
authors: Gaetano
authors: G
authors: Gulino
authors: Francesco
authors: F
authors: Sasso
authors: Giuseppe
authors: G
authors: Palermo
authors: Alfonso
authors: A
authors: D'Onofrio
authors: Marco
authors: M
authors: Racioppi
authors: Emilio
authors: E
authors: Sacco
authors: Francesco
authors: F
authors: Pinto
authors: Michele
authors: M
authors: Antonucci
authors: Alessandro
authors: A
authors: D'Addessi
authors: Pierfrancesco
authors: P
authors: Bassi
keywords: Organ potency-sparing surgery; penile cancer; penile cancer treatment; penile carcinoma; sexual outcomes
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