The sexual sequelae of testicular cancer

Basten, J.P. van; Jonker-Pool, G.; Driel, Mels F. van; Sleijfer, Dirk; Wiel, H.B.M. van der; Hoekstra, Harald J.

doi:10.1016/0305-7372(95)90031-4

Cited by 22 publications

(19 citation statements)

References 111 publications

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“…For these reasons some authors recommend only enucleation of a contralateral tumor, eventually followed by scrotal irradiation (23,24). However, the results ot" testispreserving procedures have yet to be compared with results of bilateral orchidectomized patients receiving testosterone replacement, especially with regard to sexual functioning and psychological well-being (28,29).…”

Section: Discussionmentioning

confidence: 97%

Cisplatin-based chemotherapy changes the incidence of bilateral testicular cancer

vanBasten

Hoekstra

Vandriel

et al. 1997

Annals of Surgical Oncology

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In Dutch men with a nonseminoma testicular tumor, the incidence of a contralateral testicular tumor is 3%, which is 60-fold the expected incidence rate of testicular cancer. A three times lower incidence rate of a contralateral testicular tumor was found in the chemotherapy subgroup compared with those on surveillance. This supports the hypothesis that cisplatin-based chemotherapy may eradicate carcinoma in situ or early testicular cancer.

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Section: Discussionmentioning

confidence: 97%

Cisplatin-based chemotherapy changes the incidence of bilateral testicular cancer

vanBasten

Hoekstra

Vandriel

et al. 1997

Annals of Surgical Oncology

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“…At present, the aetiology of sexual dysfunction after treatment for NSTGCT is unclear. Theoretically, treatment‐induced hormone disturbances and chemotherapy‐induced angiopathy may play a role in the aetiology of sexual dysfunction after such treatment [ 7, 12, 18].…”

Section: Discussionmentioning

confidence: 99%

“…Especially in this young group, the toxicity of treatment and its consequences on sexual function and fertility are important issues [ 6–8]. Recent reports of sexual dysfunction after treatment reveal problems in more than half of these patients [ 8, 9].…”

Section: Introductionmentioning

confidence: 99%

“…Recent reports of sexual dysfunction after treatment reveal problems in more than half of these patients [ 8, 9]. For the aetiology of sexual dysfunction, nearly all of these studies (mainly retrospective) focused on psychological factors, with the possible contribution of treatment‐induced organic factors gaining little attention [ 7–9].…”

Section: Introductionmentioning

confidence: 99%

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Objective and subjective effects of treatment for testicular cancer on sexual function

Basten¹,

Driel²,

Hoekstra³

et al. 1999

BJU International

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Objective To determine whether the treatment of patients with testicular cancer, using cisplatin combined with etoposide and bleomycin (BEP) after orchidectomy in those with disseminated disease, causes changes in sex hormones and penile vascularization, possibly related to sexual dysfunction. Patients and methods Ten patients treated with BEP were compared with 11 undergoing orchidectomy alone followed by surveillance. Sex hormone levels were analysed and cavernosal artery duplex ultrasonography performed before orchidectomy and at 6 and 12 months afterward. Patients were questioned about their sexual function. After 1 year, a visual erotic stimulation (VES) test was performed to assess penile rigidity. Results In contrast to the surveillance group, BEP‐treated patients had higher follicle‐stimulating hormone (4.6 vs 26.5 U/L) and luteinizing hormone (1.4 vs 8.2 U/L) levels, and lower testosterone levels (21.1 vs 14.7 nmol/L) at 6 months than at baseline. At 1 year, most patients had compensated hypergonadotrophic eugonadism, but Leydig cell function had recovered. Changes in cavernosal artery peak flow velocities induced by local injection with papaverine/phentolamine showed no difference between the groups before and 6 months after orchidectomy. Loss of libido and erectile dysfunction were reported more frequently by BEP‐treated patients. However, 1 year after treatment, most reported a satisfying sex life and VES resulted in a rigid erection in nearly all patients. The reported erectile dysfunction could not be explained by changes in plasma testosterone levels or diminished blood flow velocities. Conclusions After being diagnosed with testicular cancer, sexual morbidity is considerable, but within 1 year some improvement may be expected. BEP induces transient testicular dysfunction but this recovers. Although BEP is related to symptoms of angiopathy, cavernosal blood flow seems to be unaffected. These findings and the normal VES‐evoked penile rigidity suggest that sexual dysfunction is more psychological than organically induced by BEP.

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“…This approach was associated with complications related to invasive surgery, particularly damage to the sympathetic ganglia, hypogastric nerves, or postganglionic nerve fibers. These complications were responsible for sexual morbidity, mainly anejaculation and erectile disturbances [14]. Currently, the morbidity is low, and preservation of sexual and ejaculatory function is highly reliable with either a template- or nerve-sparing complete RPLND, especially in high-volume centers [15].…”

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confidence: 99%

Laparoscopic resection of a residual retroperitoneal tumor mass of nonseminomatous testicular germ cell tumors

et al. 2011

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BackgroundResection of a residual retroperitoneal tumor mass (RRRTM) is standard procedure after combination chemotherapy for metastatic nonseminomatous testicular germ cell tumors (NSTGCT).MethodsAt the University Medical Center Groningen, 79 consecutive patients with disseminated NSTGCT were treated with cisplatin combination chemotherapy between 2005 and 2007. Laparoscopic RRRTM was performed for patients with RRTM located less than 5 cm ventrally or laterally from the aorta or the vena cava. The 29 patients who fulfilled the criteria had a median age of 25 years (range, 16–59 years). The stages of disease before chemotherapy treatment according to the Royal Marsden classification were 2A (n = 6, 21%), 2B (n = 14, 48%), 2C (n = 3, 10%), and 4 with a lymph node status of N2 (n = 6, 21%).ResultsThe median duration of laparoscopy was 198 min (range, 122–325 min). The median diameter of the RRTM was 21 mm (range, 11–47 mm). Laparoscopic resection was successful for 25 patients (86%). Conversion was necessary for three patients (10%): two due to bleeding and one because of obesity. One nonplanned hand-assisted procedure (3%) also had to be performed. Histologic examination of the specimens showed fibrosis or necrosis in 12 patients (41%), mature teratoma in 16 patients (55%), and viable tumor in 1 patient (3%). The median hospital stay was 1 day (range, 1–6 days). During a median follow-up period of 47 months (29–70 months), one patient experienced an early relapse (1 month after the end of treatment) (4%).ConclusionFor properly selected patients, laparoscopic resection of RRTM is an improvement in the combined treatment of disseminated NSTGCT and associated with a short hospital stay, minimal morbidity, rapid recovery, and a neat cosmetic result. Long-term data to prove oncologic efficacy are awaited.

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The sexual sequelae of testicular cancer

Cited by 22 publications

References 111 publications

Cisplatin-based chemotherapy changes the incidence of bilateral testicular cancer

Cisplatin-based chemotherapy changes the incidence of bilateral testicular cancer

Objective and subjective effects of treatment for testicular cancer on sexual function

Laparoscopic resection of a residual retroperitoneal tumor mass of nonseminomatous testicular germ cell tumors

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