Journal of Clinical Oncology, Vol 15, 1444-1448, Copyright © 1997 by American Society of Clinical Oncology
Sexuality and fertility in long-term survivors of testicular cancer
Y Arai, M Kawakita, Y Okada and O Yoshida
Department of Urology, Faculty of Medicine, Kyoto University, Japan.
PURPOSE: We assessed the impact of different treatment modalities on
sexuality and fertility in long-term survivors of testicular cancer.
MATERIALS AND METHODS: The sample consisted of 85 testicular cancer
patients, of whom 19 had undergone chemotherapy with retroperitoneal lymph
node dissection (RPLND), 15 had received chemotherapy only, 42 had received
infradiaphragmatic radiotherapy, and nine had received surveillance
therapy. The questionnaire reported sexual function, marital status, and
issues related to fertility and childbearing. RESULTS: One fourth to one
half reported some type of sexual impairment in each group. The only
significant difference was that approximately 70% of men with RPLND
reported inability of ejaculation and a greater decline in semen volume,
which is expected. The most striking finding is that the rates and nature
of sexual dysfunction of surveillance patients were similar to other
treatment groups, except for ejaculatory function. The highest rates of
infertility distress were observed in chemotherapy patients. CONCLUSION:
These data suggest that sexual dysfunction and infertility represent the
major persisting side effects, even years after diagnosis. The hypothesis
that surveillance patients have fewer sexual problems is not upheld in this
study.
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