Abstract
The diagnosis of testicular cancer (TC) can have a considerable and persistent impact on a patient's sexuality, especially given its location. The high prevalence of TC in young adults, and the good prognosis, explain the great interest in sexual dysfunction and its influence on post-treatment quality of life. The aim of this study was to evaluate the impact of the diagnosis and treatments (inguinal orchiectomy and chemotherapy) on sex life. For this purpose, we recruited 241 TC patients attending the Laboratory of Seminology–Sperm Bank “Loredana Gandini” for sperm cryopreservation (mean age 31.3 ± 6.9 years) and 223 cancer-free healthy men who were undergoing andrological screening (mean age 32.0 ± 7.7 years). The IIEF-15 questionnaire was administered at the baseline (post-orchiectomy, pre-chemotherapy—T0) and at 6 (T1), 12 (T2), 18 (T3), 24 (T4), 48 months (T5) and >5 years (T6, median 96 months) after chemotherapy to all patients, to evaluate the following domains: erectile function (EF), orgasmic function (OF), sexual desire (SD), intercourse satisfaction (IS) and overall satisfaction (OS). A subgroup of patients also underwent blood sex hormone analysis for further correlations with IIEF scores. At the baseline, 37.7% of patients had erectile dysfunction (EF score <26) and all IIEF domains except OF showed significantly lower scores than in controls (p < 0.001). Long-term follow-up revealed persistently lower scores in TC survivors than in controls for EF, SD, IS, and OS. Furthermore, most IIEF domains did not improve significantly in TC patients during the duration of the follow-up, with the exception of EF, which showed a significant improvement from T2. Finally, no significant correlation was found between hormone levels (gonadotropin and testosterone) and IIEF-15 scores. In conclusion, TC and its treatment have a significant effect on sexuality. The absence of a clear correlation with biochemical hypogonadism suggests that this may to a large extent be due to the surgical procedure itself, or to the psychological impact of a cancer diagnosis.
Highlights
IntroductionCancer is currently the main cause of mortality worldwide
Alongside cardiovascular disease, cancer is currently the main cause of mortality worldwide
The baseline comparison of testicular cancer (TC) and CTR groups is presented in Table 2: all Index of Erectile Function 15 questionnaire (IIEF-15) domain scores were significantly worse in patients than in controls, with the exception of orgasmic function (p = 0.334)
Summary
Cancer is currently the main cause of mortality worldwide. Men in reproductive age are mainly affected by testicular cancer (TC) and lymphomas, but despite the high incidence, their 5-year survival rates are above 80–90% [2, 3] These cancer survivors will have to live with the long-term physical and psychological consequences of both their treatments (surgery, chemotherapy, radiotherapy) and the diagnosis itself [4, 5]. This has important health, social and economic repercussions, as these long-term consequences affect men in their working and reproductive years, affecting their physical capabilities as well as their reproductive and sexual health. Cancer and its treatments should certainly be considered as capable of disrupting sex life, but many patients find it difficult to discuss these problems and there is a lack of consensus on valid outcome measures for assessing sexual function in cancer patients on the basis of a broader definition of sexual health [7]—issues yet to be faced in common practice or research
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
