PRETREATMENT AND POSTTREATMENT SEXUAL LIFE IN TESTICULAR CANCER-PATIENTS - A DESCRIPTIVE INVESTIGATION

Aspects of sexuality were assessed by questionnaires in 76 testicular cancer patients after orchiectomy before further treatment and, respec tively, 6, 12 and 36 months after therapy. Before treatment 11% of the patients reported dissatisfaction with sexual life. About 20% of the patients sometimes experienced reduced libido and erectile difficultie s. Six months after therapy significantly more patients (27%) recorded an unsatisfactory sexual life as compared to the pretreatment situati on. At the 36 months' evaluation 22 of 76 evaluable patients (18%) sti ll stated that their sexual life was inferior to the pretreatment expe rience. Libido and erectile function decreased transiently during the first year after treatment in most patients. Twelve patients reported permanent 'dry ejaculation' after bilateral retroperitoneal lymph node dissection. Other sexual disturbances could not be related to specifi ed treatment modalities. Increased age at the time of diagnosis and ps ychological distress tended to correlate with the incidence of sexual problems. For about 60% of the patients the discussion of expected and experienced sexual life problems was an important issue to be discuss ed before their treatment for testicular cancer and during follow-up. The high frequency of any kind of long-lasting sexual problems (30%), though often of minor degree, warrants an adequate counselling of thes e patients before and after treatment.