Is the sexual function compromised in long-term testicular cancer survivors?

OBJECTIVES: This study explores sexual function in a large unselected sample of Norwegian testicular cancer survivors (TCSs) by comparing the results with population data.

METHODS: The study included 1084 TCSs aged 20-59 yr with mean follow-up time of 11.1 (range: 5-21) yr. They provided information about their medical, social, lifestyle, and familial situations on a questionnaire that included the Brief Male Sexual Function Inventory (BSFI). Outcome measures were mean BSFI domain scores and BSFI-based prevalence rates of sexual problems. The BSFI findings of an age-adjusted random sample of the Norwegian male population (N=929) constituted normative data (NORM). Descriptive statistics and logistic regression analyses were applied, and a significance level of <0.01 was applied.

RESULTS: Compared with NORM, TCSs had significantly worse scores on ejaculatory and sexual problems in both young (20-39 yr) and middle-aged (40-59 yr) groups. In the young group, sexual satisfaction was significantly better in TCSs versus NORM. Overall sexual problems were expressed by 38.8% of the TCSs versus 35.5% in NORM. In multivariate analyses, overall sexual problems in TCSs were significantly associated with increasing age, lack of a partner, and a higher anxiety score, while ejaculation problems showed significant association with lack of a partner, and a trend for chemotherapy and neurotoxic side effects (p=0.02).

CONCLUSIONS: Compared with NORM, ejaculatory function was compromised in TCSs. Overall sexual problems in TCSs were associated with factors also observed in NORM. Better sexual satisfaction in young TCSs compared with NORM should be noted.