SEXUAL DYSFUNCTION IN NONSEMINOMA TESTICULAR CANCER-PATIENTS IS RELATED TO CHEMOTHERAPY-INDUCED ANGIOPATHY

Purpose: To establish the prevalence of sexual dysfunctions after diff erent treatment modalities for non-seminomatous testicular germ cell t umor (NSTGCT) and to investigate whether treatment-induced angiopathy and neuropathy is related to sexual dysfunction. Patient and Methods: A questionnaire assessing sexual dysfunction was sent to 255 NSTGCT su rvivors, Polychemotherapy (PCT) regimens (cisplatin, vinblastine, and bleomycin [PVB], vinblastine substituted by etoposide [BEP], or cispla tin substituted by carboplatin [CEB], etoposide combined with cisplati n [EP], or with ifosfamide and cisplatin [VIP] were compared regarding treatment-induced angiopathy and neuropathy, Sexual dysfunctions were related to Raynaud's phenomenon and acral paresthesia, Results: Among the 215 responders, 56 (26%) had been treated by orchidectomy and sur veillance, 42 (19.6%) by PCT, and 117 (54.4%) by PCT and resection of residual retroperitoneal turner mass (RRRTM), Overall, loss of libido was reported by 19.1%, decreased arousal by 11.2%, erectile dysfunctio n by 12.1%, decreased intensity of orgasm by 20%, and ejaculatory prob lems by 28%. Patients treated with PVB suffered more often from Raynau d's phenomenon compared with those treated with other regimens (40.4% v 29%; P < .05) and from paresthesia (31.6% v 14.7%; P < .05). Patient s with Raynaud's phenomenon had more often erectile dysfunction (28.8% ) compared with those without (8.4%) (P < .05). Conclusion: Compared w ith orchidectomy alone, PCT, with or without RRRTM, induced more often posttreatment sexual dysfunction. Compared with other chemotherapeuti c regimens, signs of angiopathy and neuropathy were most prevalent ire those treated with PVB. Erectile dysfunction was related to the chemo therapy-induced Raynaud's phenomenon but not to acral paresthesia. (C) 1997 by American Society of Clinical Oncology.