Impact of cancer therapy on post‐treatment ejaculation disorder and sexual life in testicular cancer survivors

Abstract

ObjectiveTo evaluate the impact of cancer therapy on post‐treatment ejaculation in patients with testicular cancer.MethodsA total of 74 testicular cancer survivors provided completed International Index of Erectile Function‐15 questionnaires before and after treatment between 2010 and 2017. Sexual function, particularly ejaculatory function, was evaluated before and after treatment. In this study, patients who answered “1 = almost never/never” or “2 = a few times” for questionnaire number 9 (ejaculation frequency) were defined as having “ejaculation disorder.”ResultsOf 74 testicular cancer survivors, 50 (68%) had no ejaculation disorders before treatment. Four (44%) of nine survivors, who received chemotherapy and retroperitoneal lymph node dissection, developed ejaculation disorders after treatment. On multivariate analysis, retroperitoneal lymph node dissection was a significant predictor of post‐treatment ejaculation disorder (P = 0.042). Of 60 survivors with evaluable ejaculation function after treatment, 24 (40%) did not attempt sexual intercourse, and multivariate analysis showed ejaculation disorder had a significant negative impact on having sexual intercourse (P = 0.035). Furthermore, the mean International Index of Erectile Function‐15 scores in the groups with and without ejaculation disorders after treatment were 24.0 and 51.9, respectively (P < 0.001).ConclusionEjaculation disorders occur at high rate after retroperitoneal lymph node dissection. Many testicular cancer survivors reporting no sexual intercourse have ejaculation disorders, suggesting an adverse impact on sexual life. Urologists should provide proper counselling regarding the risk of ejaculation disorder and its possible impact on sexual life.

Sexual function using the EORTC QLQ‐TC26 in testicular cancer survivors: A multi‐institutional, cross‐sectional study

“…[14][15][16][17] However, treatment modality might have no obvious influence on erectile dysfunction, 16 consistent with our previous report. 10 In addition, we reported that ejaculation disorders occurred at a high rate following RPLND, and TC survivors after RPLND showed lower sexual QOL in a single-institutional study. 10 Recently, a multi-institutional, cross-sectional study was conducted to evaluate health-related QOL and fertility among TC survivors using the EORTC QLQ-TC26 in Japan.…”

“…10 In addition, we reported that ejaculation disorders occurred at a high rate following RPLND, and TC survivors after RPLND showed lower sexual QOL in a single-institutional study. 10 Recently, a multi-institutional, cross-sectional study was conducted to evaluate health-related QOL and fertility among TC survivors using the EORTC QLQ-TC26 in Japan. 12,[18][19][20] The EORTC QLQ-TC26 includes the questionnaire about sexual functioning; erectile and ejaculatory functions.…”

“…However, there are a few reports on the QOL including sexual function among Asian TC survivors, and sufficient objective information has yet to be accumulated. [8][9][10] Therefore, we developed and validated a new questionnaire, the Japanese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Testicular Cancer 26 (EORTC QLQ-TC26), to assess QOL in Japanese TC patients. 11,12 Sexual disorders such as erectile dysfunction and ejaculation disorder have been reported in patients treated with different treatments including retroperitoneal lymph node dissection (RPLND) and chemotherapy for TC.…”

Fertility and sexual dysfunction in young male cancer survivors

“…In a multivariate analysis, RPLND was an independent factor for EjD ( p = 0.042). They also used multivariate analysis to investigate the causative factors in 60 patients who stopped having sexual intercourse after treatment and found that the presence or absence of a partner and EjD were independent factors for the cessation of sexual intercourse (EjD odds ratio 14.8, 95% CI 1.21–181.26) 56 . EjDs after RPLND include retrograde ejaculation (RE) besides failure of emission; Hsaio et al examined the cause of postoperative EjD in 26 patients and found four patients with RE 57 .…”

Ejaculation Disorders in Male Patients with Cancer: A Systematic Review and Meta-Analysis of Prevalence

“…5 Recent evidence reported that ejaculatory dysfunctions (EjDs) occur at a high rate after retroperitoneal lymph node dissection, frequently performed in testicular and other pelvic cancers. 6 Moreover, EjDs are commonly associated with transurethral resection associated with an enlarged prostate and also represent significant side effects following the treatment lower urinary tract symptoms caused by prostate cancer. 7 To date, the main reviews and meta-analyses consider the association between specific cancer and EjDs and erectile dysfunction, but no comprehensive reviews exist on their prevalence.…”