title: Long-term recovery of normal sexual function in testicular cancer survivors.
abstract: Testicular cancer (TC) is the most common solid cancer in men between the third and fourth decade of life. Due to successful treatment approaches, TC survivors (TCSs) have long life expectancy, but with numerous potential long-term sequelae, including sexual dysfunction. We investigated predictors of long-term normal sexual function (SF) recovery in TCSs. Sociodemographic, medical, and psychometric data were analyzed in 143 Caucasian-European TCSs, who underwent orchiectomy at a single institution. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Patients completed the International Index of Erectile Function (IIEF). Statistical models tested the association between predictors (including age at surgery, body mass index, CCI, and adjuvant therapy: radiotherapy [RT], chemotherapy [CT], CT followed by retroperitoneal lymph node dissection [RPLND] and RPLND alone) and the long-term recovery of normal SF (defined as IIEF-erectile function [EF] ≥26, and sexual desire [SD], intercourse satisfaction [IS] orgasmic function [OF], and overall satisfaction [OS] domain scores in the upper tertiles). At a mean follow-up of 86 months, 35 (25.5%) TCSs had erectile dysfunction (ED), with 16 (11.2%) experiencing severe ED. Median time of EF recovery was 60, 60, and 70 months after CT, RT, and RPLND, respectively. Only adjuvant RT emerged as an independent predictor of nonrecovery of normal EF (HR: 0.55, P= 0.01). Neither adjuvant CT nor CT plus RPLND or RPLND alone significantly impaired the recovery of normal erections. Adjuvant therapy was not associated with impaired recovery of normal sexuality as a whole, considering the IIEF-SD, -OF, -IS, and OS domains.
authors.forename: Paolo
authors.initials: P
authors.lastname: Capogrosso
authors.forename: Luca
authors.initials: L
authors.lastname: Boeri
authors.forename: Matteo
authors.initials: M
authors.lastname: Ferrari
authors.forename: Eugenio
authors.initials: E
authors.lastname: Ventimiglia
authors.forename: Giovanni
authors.initials: G
authors.lastname: La Croce
authors.forename: Umberto
authors.initials: U
authors.lastname: Capitanio
authors.forename: Alberto
authors.initials: A
authors.lastname: Briganti
authors.forename: Rocco
authors.initials: R
authors.lastname: Damiano
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
authors.affiliation: Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan; Research Doctorate Program in Urology, Magna Graecia University, Catanzaro, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Salonia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019529:Sexuality; D013736:Testicular Neoplasms / Q000503:physiopathology*; D055815:Young Adult