Changes in sexual functioning after germ cell tumor (GCT) therapy estimated by patients and their partners

Abstract

5086 Background: Only few studies have addressed sexual difficulties and sexual satisfactions as an area of subjective quality- of-life in long-term survivors of GCT. We investigated the sexual functioning and sexual well-being in patients (pts) and their partners after GCT therapy. Methods: 474 pts treated for GCT between 1979 and 2000 were asked to complete a self-report questionnaire on psychosocial dimensions such as sexual functioning and partnership. Female partners were asked to complete a part of the questionnaire. Results: A completed questionnaire was returned by 341 of 474 pts (71.9%) and by 196 female partners of the responding pts (57.5%). The median age of the pts was 41.9 years at the time of the study and 31.2 years at the time of GCT diagnosis (median follow-up 9.6 yrs). Of 327 pts who provided information on their marital status 203 (62%) were married/lived in a partnership, 101 (31%) were single and 24 (7%) divorced. 81 pts (25%) complained of decreased sexual attractivity which was more frequently reported in pts divorced (42%) than in singles (30%) or married pts (19%). Libido loss, arousal loss, decreased erection, decreased ejaculation and decreased orgasm intensity were reported by 66 (19%), 73 (21%), 70 (21%), 110 (32%) and 70 (21%) pts, respectively. All of these complaints more frequently occurred in pts ≥40 yrs at time of the study compared to age <40 (p<0.001). Of responding couples more males than females reported to be sexually unsatisfied (32% vs 23%) after GCT therapy. Sexual satisfaction decreased with the duration of the partnership in females (p=0.005) but not in males (p=0.5). More pts than female partners reported fear of sexually dissatisfying the partner before (10% vs 4%) and after GCT therapy (24% vs 7%). More females (22%) than pts (14%) reported a positive influence of the disease on their partnership with a significant difference observed in partnerships of <1 year duration (67% vs 32%, p=0.007). Conclusions: About 20% of pts are limited in sexual functioning after GCT therapy. Overall, more female partners than pts have a favorable perception of the influence of the disease on the partnership. No significant financial relationships to disclose.