Assessment of selected quality of life domains in patients who have undergone conservative or radical surgical treatment for penile cancer: an observational study

Abstract

Background Surgery is the standard treatment for organ-restricted penile cancer, but it is also a disfiguring procedure that can profoundly affect quality of life. Using a survey, in this study we assessed the effect of different surgical invasiveness on satisfaction in selected life domains of patients who underwent penile-sparing surgery and partial penectomy. Methods: Forty patients who underwent penile-sparing surgery (n=13) or partial penectomy (n=27) were enrolled in the study. The response rate was 71%. Information was obtained after surgery on sexuality, self-esteem, masculinity and partner relationships using the International Index of Erectile Function, the Self-Esteem Scale and the Conformity to Masculinity Norms Inventory questionnaires. We evaluated the effect of primary surgery type on selected domains of quality of life and correlations between study variables after surgery. Results: High self-esteem, satisfactory erectile function and masculinity results in both groups were comparable to those in the published literature. Men who underwent less disfiguring treatment had a significantly higher sense of masculinity than those who underwent partial penectomy (P=0.05). No significant differences were observed in erectile dysfunction and self-esteem. The level of aggressiveness of a surgical procedure was a predictor of sense of masculinity (P=0.01), but was not associated with self-esteem and sexual dysfunction (P=0.28 and P=0.55 respectively); 83% of patients were able to satisfactorily maintain partner relationships. Conclusions: Disfiguring treatments for penile cancer significantly interfere with the sense of masculinity, but sexual functioning and self-esteem do not differ according to the type of surgical procedure. Most men maintained stable partner relationships after surgery, regardless of surgery type.

Sexual function in the penile cancer survivor: a narrative review

“…Notably, no statistically significant difference was noted in the domains of erectile function, sexual desire, overall sexual satisfaction, or intercourse satisfaction; however, those treated with partial penectomy reported a higher degree of appearance concerns than their counterparts. A Polish study by Sosnowski et al reported similar outcomes (31). Using the IIEF, the authors assessed sexual outcomes in 40 men using validated questionnaires in sexually active patients who underwent circumcision/WLE and partial penectomy.…”

What Is the Most Effective Management of the Primary Tumor in Men with Invasive Penile Cancer: A Systematic Review of the Available Treatment Options and Their Outcomes

“…Overall 3283 abstracts were screened and 235 studies were retrieved for full-text screening. Eighty-eight studies including 9758 patients were eligible for assessment: 16 NRCSs (1911 patients) [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] and 72 CSs (7864 patients) [6] , [7] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , …”

“…The baseline characteristics of NRCSs and CSs are presented in Table 2 , Table 3 . All 16 NRCSs were retrospective studies, 12 comparing penile-sparing surgery with amputative surgery [11] , [12] , [13] , [14] , [15] , [16] , [17] , [20] , [21] , [22] , [24] , [25] and four comparing radiotherapy with penile surgery [10] , [18] , [19] , [23] . All 72 CSs were retrospective, with 39 studies addressing penile surgery [6] , [7] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , [85] , [86] , [87] , [88] , [89] , [90] , [91] , [92] , 20 reporting on radiotherapy [26] , [27] , [28] , [29] , [30] , [31] ...…”

“…comparative 51 PSS: T1: 10/15 (66.7%) T2: 3/15 (20.0%) T3: 2/15 (13.3%) AS: T1: 11/36 (30.5%) T2: 21/36 (58.3%) T3: 2/36 (5.5%) T4: 2/36 (5.5%) PSS (Cx, Gx, laser, EBRT; n = 15) vs AS (PP and TP; n = 36) PSS: 33.3% (5/15) T1: 45% (5/11) T2: 0/2 (0%) T3: 0/2(0%) AS: 88.9% (33/36) T1: 100% (11/11) T2: 85.7% (18/21) T3: 100% (3/3) NR NR NR NR NR 29.40% Assessed Sosnowski et al (2017) [12] Retrosp. comparative 55 Tx: 4 (7.3%) T1–4: 51 (92.7%) PSS: 13/51 (25.5%; circumcision, WLE) AS: 38/51 (74.51%; PP 27/38, TP 11/38) NR NR EORTC QLQ-C30 v3.0 Social functioning (PSS 82, AS 75–85) Cognitive functioning (PSS 85, AS 75–82) Emotional functioning (PSS 78, AS 66–69) Role functioning (PSS 78, AS 75–83) Physical functioning (PSS 83, AS 67–81) Global health status (PSS 63, AS 50–56) NR NR NR NR Assessed Sosnowski et al (2019) [13] Retrosp. comparative 56 Tx or Tis: 16 (28.6%) T1–4: 40 (71.4%) PSS: 13/40 (32.5%; circumcision, WLE) AS: 27/40 (67.5%; PP 27/27) NR NR SES PSS: mean score 28.81 PP: mean score 29.62 CMNI-22 PSS: mean score 28.26 PP: mean score 25.31 Post-op IIEF-5 PSS: mean score 13.59 PP: mean score 16.77 ( p = 0.218) Self Esteem Scale: PSS: 28.81 ± 3.99 PP: 29.62 ± 3.78 ( p = 0.460) NR NR NR Assessed Veeratterapillay et al (2015) [14] Retrosp.…”

Influence of the health status and other relevant factors on the quality of life of elderly people

“…Although the quality of life could be the best described as statistical index which is based on various parameters, like economic related, health related and environmental related [9] . Poor social networks [10] and additional contributing features such as poor living conditions, poverty and poor social relations [11] underwrite deterioration in quality of life.…”