SEXUAL FUNCTIONING AFTER MULTIMODALITY TREATMENT FOR DISSEMINATED NONSEMINOMATOUS TESTICULAR GERM CELL TUMOR

Abstract

No AccessJournal of UrologyClinical Urology: Original Articles1 Oct 1997SEXUAL FUNCTIONING AFTER MULTIMODALITY TREATMENT FOR DISSEMINATED NONSEMINOMATOUS TESTICULAR GERM CELL TUMOR J.P. Van Basten, G. Jonker-Pool, M.F. Van Driel, D. TH. Sleijfer, J.H.J. Droste, H.B.M. Van De Wiel, H. Schraffordt Koops, W.M. Molenaar, and H.J. Hoekstra J.P. Van BastenJ.P. Van Basten , G. Jonker-PoolG. Jonker-Pool , M.F. Van DrielM.F. Van Driel , D. TH. SleijferD. TH. Sleijfer , J.H.J. DrosteJ.H.J. Droste , H.B.M. Van De WielH.B.M. Van De Wiel , H. Schraffordt KoopsH. Schraffordt Koops , W.M. MolenaarW.M. Molenaar , and H.J. HoekstraH.J. Hoekstra View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)64228-9AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined sexual functioning after chemotherapy for disseminated nonseminomatous testicular germ cell tumor, and evaluated the impact of resection of post-chemotherapy residual retroperitoneal tumor. Materials and Methods: A total of 155 consecutive patients treated with chemotherapy for disseminated nonseminomatous testicular germ cell tumor (between 1980 and 1994) was questioned about their sexual functioning. The patients were divided in 2 subgroups: patients treated with or without resection of post-chemotherapy residual retroperitoneal tumor. Volume and location (divided into left para-aortal or right paracaval/interaortacaval) of the resected tumor were related to absence of ejaculation as well as decreased semen amount. In addition, libido, arousal, erection and orgasm were related to ejaculatory dysfunction. Results: A total of 43 patients (27.7%) was treated with chemotherapy only and 112 (72.3%) had additional resection of post-chemotherapy residual retroperitoneal tumor mass. Overall, 22.4% reported loss of libido, 14.1% decreased arousal, 16% erectile dysfunction, 23.1% decreased orgasmic intensity, 17.4% decreased semen amount and 18.7% complete absence of antegrade ejaculation. With exception of absence of ejaculation, sexual dysfunctions were reported in similar frequencies in both treatment subgroups. In the resection of post-chemotherapy residual retroperitoneal tumor subgroup, 25.9% of the patients had complete absence of ejaculation. The other sexual dysfunctions were related neither to decreased semen amount nor to complete absence of ejaculation. The mean volume of resected tumor was higher (95 cm.3) in patients with absence of ejaculation than in those without (40 cm.3), and patients with right paracaval/interaortacaval tumor (20 of 58, 34.5%) reported more often absence of ejaculation than those with left para-aortal tumor (9 of 54, 16.7%). Conclusions: In patients treated for disseminated nonseminomatous testicular germ cell tumor, post-chemotherapy sexual morbidity cannot be neglected. Except for loss of antegrade ejaculation, sexual dysfunctions are not related to resection of post-chemotherapy residual retroperitoneal mass. A high volume of tumor and a right paracaval/interaortacaval location predispose to loss of antegrade ejaculation. References 1 : Ten-year survival and late sequelae in testicular cancer patients treated with cisplatin, vinblastine and bleomycin.. J. Clin. Oncol.1989; 7: 1099. Google Scholar 2 : Sexual dysfunction after testicular cancer. Eur. J. Cancer1995; 31A: 188. 905, abstract. 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Abstract, Google Scholar 47 : Para-aortic lymphadenectomy after chemotherapy for metastatic non-seminomatous germ cell tumours: prognostic value and therapeutic benefit.. Brit. J. Urol.1993; 71: 208. Google Scholar From the Departments of Surgical Oncology, Medical Psychology, Urology, Medical Oncology and Pathology, Groningen University Hospital, Groningen, The Netherlands, and Department of Epidemiology and Statistics, University Institute of Antwerpen, Antwerp, Belgium.© 1997 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 158Issue 4October 1997Page: 1411-1416 Advertisement Copyright & Permissions© 1997 by American Urological Association, Inc.MetricsAuthor Information J.P. Van Basten More articles by this author G. Jonker-Pool More articles by this author M.F. Van Driel More articles by this author D. TH. Sleijfer More articles by this author J.H.J. Droste More articles by this author H.B.M. Van De Wiel More articles by this author H. Schraffordt Koops More articles by this author W.M. Molenaar More articles by this author H.J. Hoekstra More articles by this author Expand All Advertisement PDF downloadLoading ...