title: Quality of life for patients treated for penile cancer.
abstract: OBJECTIVE
  We assessed the impact of primary surgery, including penile sparing surgery vs (partial) penectomy and lymphadenectomy, on sexuality and health related quality of life.
  
  
  METHODS
  We invited 147 patients surgically treated for penile cancer at our institution between 2003 and 2008 to complete the IIEF-15, SF-36®, IOC (version 2) and questions on urinary function. We evaluated the impact of primary surgery type and lymphadenectomy on these outcomes. We also compared patient SF-36 scores with those of an age and gender matched normative sample from the general Dutch population.
  
  
  RESULTS
  A total of 90 patients (62%) returned a completed questionnaire. Surgery type and extent were not associated significantly with most of the study outcomes assessed. However, men who underwent (partial) penectomy reported significantly more problems than those treated with penile sparing surgery, including orgasm (effect size 0.54, p = 0.031), appearance concerns (effect size 0.61, p = 0.008), life interference (effect size 0.49, p = 0.032) and urinary function (83% vs 43%, p <0.0001). Men who underwent lymphadenectomy reported significantly more life interference (effect size 0.50, p = 0.037). The patient sample scored significantly better than the normative sample on the SF-36 physical component (p = 0.044) and the bodily pain subscale (p <0.001).
  
  
  CONCLUSIONS
  Few differences were observed in sexuality and health related quality of life as a function of primary surgery and lymphadenectomy. However, (partial) penectomy and lymphadenectomy were associated with more problems with orgasm, body image, life interference and urination. Additional longitudinal studies are warranted to evaluate individual changes with time in these outcomes.
authors.affiliation: Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
authors.forename: Jacobien M
authors.initials: JM
authors.lastname: Kieffer
authors.affiliation: Department of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
authors.forename: Rosa S
authors.initials: RS
authors.lastname: Djajadiningrat
authors.affiliation: Department of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
authors.forename: Erik A M
authors.initials: EA
authors.lastname: van Muilekom
authors.affiliation: Department of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
authors.forename: Niels M
authors.initials: NM
authors.lastname: Graafland
authors.affiliation: Department of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
authors.forename: Simon
authors.initials: S
authors.lastname: Horenblas
authors.affiliation: Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands. Electronic address: n.aaronson@nki.nl.
authors.forename: Neil K
authors.initials: NK
authors.lastname: Aaronson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010412:Penile Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D019529:Sexuality / Q000523:psychology*; D011795:Surveys and Questionnaires; D013521:Urologic Surgical Procedures, Male
chemical_list: D000970:Antineoplastic Agents
keywords: carcinoma; penis; physiological; quality of life; questionnaires; sexual dysfunction; squamous cell