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Impact of cancer therapy on post‐treatment ejaculation disorder and sexual life in testicular cancer survivors
Author(s) -
Koyama Juntaro,
Yamashita Shinichi,
Yamada Shigeyuki,
Fujii Shinji,
Goto Takuro,
Katayama Hiromichi,
Satake Yohei,
Sato Takuma,
Shimada Shuichi,
Kawasaki Yoshihide,
Kawamorita Naoki,
Mitsuzuka Koji,
Arai Yoichi,
Ito Akihiro
Publication year - 2021
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.14403
Subject(s) - medicine , ejaculation , sexual function , retroperitoneal lymph node dissection , testicular cancer , premature ejaculation , dissection (medical) , retrograde ejaculation , urology , sexual intercourse , sexual dysfunction , gynecology , cancer , surgery , prostate , population , psychology , environmental health , psychoanalysis
Objective To evaluate the impact of cancer therapy on post‐treatment ejaculation in patients with testicular cancer. Methods A total of 74 testicular cancer survivors provided completed International Index of Erectile Function‐15 questionnaires before and after treatment between 2010 and 2017. Sexual function, particularly ejaculatory function, was evaluated before and after treatment. In this study, patients who answered “1 = almost never/never” or “2 = a few times” for questionnaire number 9 (ejaculation frequency) were defined as having “ejaculation disorder.” Results Of 74 testicular cancer survivors, 50 (68%) had no ejaculation disorders before treatment. Four (44%) of nine survivors, who received chemotherapy and retroperitoneal lymph node dissection, developed ejaculation disorders after treatment. On multivariate analysis, retroperitoneal lymph node dissection was a significant predictor of post‐treatment ejaculation disorder ( P = 0.042). Of 60 survivors with evaluable ejaculation function after treatment, 24 (40%) did not attempt sexual intercourse, and multivariate analysis showed ejaculation disorder had a significant negative impact on having sexual intercourse ( P = 0.035). Furthermore, the mean International Index of Erectile Function‐15 scores in the groups with and without ejaculation disorders after treatment were 24.0 and 51.9, respectively ( P < 0.001). Conclusion Ejaculation disorders occur at high rate after retroperitoneal lymph node dissection. Many testicular cancer survivors reporting no sexual intercourse have ejaculation disorders, suggesting an adverse impact on sexual life. Urologists should provide proper counselling regarding the risk of ejaculation disorder and its possible impact on sexual life.