title: Sexual function after treatment for sacrococcygeal teratoma during childhood.
abstract: BACKGROUND
  Children treated for sacrococcygeal teratoma (SCT) may suffer from sexual dysfunction later in life because of the extended pelvic surgery performed, however, structured evaluations have not been performed yet.
  
  
  METHODS
  The Female Sexual Function Index (FSFI), the International Index of Erectile Function (IIEF) and the Body Image Questionnaire (BIQ) were sent to patients (≥18years) treated for SCT in the Dutch pediatric surgical centers after 1970.
  
  
  RESULTS
  Forty-five of 76 patients returned the questionnaires; 28 women (median age 27.3years, range 18.3-41.0) and seven men (median age 22.0years, range 19.1-36.5) were eligible for analysis. The FSFI and IIEF results were compared to healthy controls. Female patients scored significantly lower on the desire (p=0.014), arousal (p=0.013) and lubrication domain (p=0.019). FSFI total-scores of female patients were significantly lower compared to controls [median 30.5 (IQR 28.6-31.4) vs. median 32.4 (IQR 30.6-33.45) p≤0.001] but were above the threshold value for sexual dysfunction. Males reported normal erectile function and penetration ability with normal ejaculation. Females had significant lower BIQ results compared to males; BIQ-cosmesis scores were moderately correlated to the FSFI-desire score (r=-0.37, p=0.028).
  
  
  CONCLUSIONS
  SCT resection in girls may result in diminished sexual function at adult age with worse self-perceived body image. The possibility of sexual complaints should be integrated in the surveillance strategies for these patients.
authors.affiliation: Department of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Marijke E B
authors.initials: ME
authors.lastname: Kremer
authors.affiliation: Department of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Joep P M
authors.initials: JP
authors.lastname: Derikx
authors.affiliation: Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Andrea
authors.initials: A
authors.lastname: Peeters
authors.affiliation: Department of Psychosomatic Gynecology and Sexology, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Moniek M
authors.initials: MM
authors.lastname: Ter Kuile
authors.affiliation: Department of Pediatric Surgery, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Robertine
authors.initials: R
authors.lastname: van Baren
authors.affiliation: Pediatric Surgical Center of Amsterdam (Emma Children's Hospital AMC and VU Medical Center), Amsterdam, the Netherlands.
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Heij
authors.affiliation: Department of Pediatric, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Marc H W A
authors.initials: MH
authors.lastname: Wijnen
authors.affiliation: Department of Pediatric Surgery, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.
authors.forename: René M H
authors.initials: RM
authors.lastname: Wijnen
authors.affiliation: Department of Pediatric Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: David C
authors.initials: DC
authors.lastname: van der Zee
authors.affiliation: Department of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands. Electronic address: e.vanheurn@amc.uva.nl.
authors.forename: L W Ernest
authors.initials: LW
authors.lastname: van Heurn
mesh_terms: D000293:Adolescent; D000328:Adult; D001828:Body Image; D016022:Case-Control Studies; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D010386:Pelvic Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D012189:Retrospective Studies; D012445:Sacrococcygeal Region; D057566:Self Report; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D020018:Sexual Dysfunctions, Psychological / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D013724:Teratoma / Q000601:surgery*; D055815:Young Adult
keywords: Germ cell tumor; Sequelae; Sexual function