Sexuality and fertility in long-term survivors of testicular cancer

Purpose: We assessed the impact of different treatment modalities on sexuality and fertility in long-term survivors of testicular cancer. Materials and Methods: The sample consisted of 85 testicular canter patients, of whom 19 had undergone chemotherapy with retroperitoneal lymph node dissection (RPLND), 15 had received chemotherapy only, 42 had received infradiaphragmatic radiotherapy, and nine had received surveillance therapy. The questionnaire reported sexual function, marital status, and issues related to fertility and childbearing. Results: One fourth to one half reported some type of sex impairment in each group, The only significant difference was that approximately 70% of men with RPLND reported inability of ejaculation and a greater decline in semen volume, which is expected. The most striking finding is that the rates and nature of sexual dysfunction of surveillance patients were similar to other treatment groups, except for ejaculatory function. The highest rates of infertility distress were observed in chemotherapy patients. Conclusion: These data suggest that sexual dysfunction and infertility represent the major persisting side effects, even years after diagnosis. The hypothesis that surveillance patients have fewer sexual problems is not upheld in this study. (C) 1997 by American Society of Clinical Oncology.