BACKGROUND. This retrospective study evaluates changes in sexual funct
ioning after treatment for testicular cancer and investigates whether
there is a relationship with different treatment modalities. METHODS.
A self-reported questionnaire was sent to 337 men who had been treated
for testicular cancer at the University Hospital Groningen between 19
77 and 1994. Medical information was obtained from the patient records
. RESULTS. A response was received from 287 men (85%); 264 patients we
re included in this study (78%). The mean patient age at follow-up was
37.7 years (range, 17-71 years). The mean follow-up period was 6.7 ye
ars (range, 0.25-18 years). Decrease in sexual functions was reported
by 40% of patients (decrease in libido: 19%; arousal: 12% erection: 12
.5%; orgasm: 19%; and ejaculation: 26%). Moreover, 23.5% of patients r
esponding reported decreased sexual activity and 12.5% were dissatisfi
ed with their sexual functioning. Patients with Stage II-IV nonseminom
a who had been treated with polychemotherapy (PCT) with or without res
ection of residual retroperitoneal tumor mass (RRRTM) (PCT +/- RRRTM)
reported a significantly sharper decrease in sexual functioning than p
atients who had been followed with a wait-and-see policy (W & S) (Stag
e I nonseminoma patients). It was noteworthy that patients treated by
PCT alone reported more sharply decreased sexual functioning than pati
ents treated by PCT + RRRTM, Patients treated by radiotherapy (Stage I
-IIA seminoma) did not report findings significantly different from th
e W & S group. CONCLUSIONS. Testicular cancer patients are at risk for
reduced sexual functioning, especially when treated by chemotherapy,
with or without resection of residual tumor. Although chemotherapy way
influence somatic aspects of sexual functioning, it appears that psyc
hologic factors arising From the confrontation with testicular cancer
play a strongly mediating (if not determining) role. (C) 1997 American
Cancer Society.