Sexual dysfunction in testicular cancer patients subjected to post-chemotherapy retroperitoneal lymph node dissection: a focus beyond ejaculation disorders

Andrologia. 2016 May;48(4):425-30. doi: 10.1111/and.12462. Epub 2015 Aug 13.

Abstract

Post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) represents an integral part of multidisciplinary treatment of advanced germ cell cancer; however, it is associated with a high complications rate. The present study aimed to describe sexual disorders in 53 patients with testicular cancer who underwent full bilateral, non-nerve-sparing PC-RPLND in our institution, focusing beyond ejaculatory dysfunction. The International Index for Erectile Function (IIEF) questionnaire was used as diagnostic tool of male sexual functioning pre-operatively and three months after RPLND, while post-operatively patients were asked to describe and evaluate changes in selected sexual parameters. Study findings demonstrate mixed pattern of changes in sexual functioning, with no difference in erectile functioning before and after operation. However, orgasmic function and intercourse and overall sexual satisfaction were found significantly impaired post-operatively. Sexual desire and frequency of attempted sexual intercourses were found significantly increased post-operatively, in comparison with pre-operative levels. With regard to patients' subjective perception on sexual functioning alterations after PC-RPLND, a significant number of patients reported higher levels of sexual desire, no difference in erectile function and worse orgasmic function and satisfaction post-operatively. Thus, patients subjected to PC-RPLND should be closely and routinely evaluated due to close relationship of sexual dissatisfaction with secondary psychological disorders.

Keywords: Post-chemotherapy retroperitoneal lymph node dissection; retroperitoneal lymph node dissection; sexual disorders; testicular cancer.

MeSH terms

  • Adult
  • Antineoplastic Agents / therapeutic use
  • Coitus / psychology
  • Combined Modality Therapy
  • Ejaculation*
  • Erectile Dysfunction / etiology*
  • Erectile Dysfunction / psychology
  • Greece
  • Humans
  • Lymph Node Excision / adverse effects*
  • Lymph Node Excision / methods
  • Lymph Node Excision / psychology
  • Male
  • Neoplasms, Germ Cell and Embryonal / drug therapy
  • Neoplasms, Germ Cell and Embryonal / surgery*
  • Orgasm
  • Prospective Studies
  • Retroperitoneal Space
  • Surveys and Questionnaires
  • Testicular Neoplasms / drug therapy
  • Testicular Neoplasms / surgery*
  • Young Adult

Substances

  • Antineoplastic Agents