Sexuality in Surgically Treated Carcinoma Penis Patients and Their Partners

Abstract

Most common treatment offered to carcinoma penis patients is surgery. This results in not only mutilation of the genitals but also affects their sexuality. The treating physician fails to address the issue due to the paucity of the data in this regard. Hence, we decided to evaluate sexuality in these patients after surgical treatment for penile cancer. Most of the times, their partners also face problems of sex and sexuality, regarding which there is no literature. Hence, we decided to include their partners also in the study. We retrieved records of the patients who underwent surgical treatment for carcinoma penis at our institute. After obtaining ethical committee approval, they were invited along with their partners for personal interview. After obtaining written informed consent from each of them, they were administered sexual functioning questionnaire (SFQ). Sexuality was evaluated based on the scores obtained. Performance anxiety was reported by majority of these patients. Their sexual interest, arousal and desire remained almost intact with reduction in satisfaction more so in total penectomised patients. Though the partners had accepted the global reduction in sexuality as their fate, their interpersonal relationship remained little disturbed. The study reveals that sexuality is more than the sexual intercourse alone. Proper pre-operative counselling of these patients and their partners by the treating urologist helps better post-treatment adjustment with regards to sexuality in these patients as well as their partners.

What are the unmet supportive care needs of men affected by penile cancer? A systematic review of the empirical evidence

“…Of the 1725 retrieved from the search, 1662 articles were excluded following the application of the inclusion and exclusion criteria during the title and abstract screening, see Figure 1. In total, 62 fulltext publications were reviewed in full and 45 were excluded with reasons and 18 articles were included, reporting the results from 17 studies in the final review (Kieffer et al, 2014, Sosnowski et al, 2016, Wan et al, 2018, Windahl et al, 2004, Witty et al, 2013, Mortensen and Jakobsen, 2013, Skeppner and Fugl-Meyer, 2015, Skeppner et al, 2008, Opjordsmoen et al, 1994, Bhat et al, 2018, Bullen et al, 2010, Drager et al, 2017, Ficarra et al, 2000, Gordon et al, 2017, Bullen et al, 2009, D'Ancona et al, 1997, Bullen et al, 2010, Bullen et al, 2009.…”

“…The devastating impact that a new diagnosis of penile cancer and related treatments was identified as a clinically significant theme across many of the studies related to unmet intimacy needs. Several studies identified that participants reported that their relationship with their partners was affected by sexual dissatisfaction (Bhat et al, 2018, Ficarra et al, 2000, Skeppner and Fugl-Meyer, 2015, Skeppner et al, 2008, Sosnowski et al, 2016, Wan et al, 2018. Moreover, in one study, 90% of the participants experienced anxiety in relation to their sexual performance (Bhat et al, 2018).…”

“…The methodological quality assessment of the primary studies was conducted in parallel with the data extraction, Table 4. There are a number of shortcomings across the studies which included small sample sizes (Drager et al, 2017, Ficarra et al, 2000, Opjordsmoen et al, 1994, Sosnowski et al, 2016, Wan et al, 2018 lack of transparency in qualitative methodology (Mortensen and Jakobsen, 2013, Bhat et al, 2018, Ficarra et al, 2000 and limited reporting of the clinical and demographic characteristics across the study participants.…”

Sexual function in the penile cancer survivor: a narrative review

“…Unsurprisingly, the patients who underwent total penectomy reported higher levels of sexual desire but less sexual satisfaction than their partial penectomy counterparts which affected the relationship with their partners. The authors reported an absolute overall reduction in sexual satisfaction among those treated with partial penectomy (35). The outcomes were poorer still in those treated with total penectomy.…”

“…Bhat et al described twelve patients, two had undergone total penectomy and ten underwent partial penectomy (35). The partial penectomy cohort had intact masculine selfimage prior to treatment that was lost in all ten patients postoperatively.…”