Orchiectomy followed by infradiaphragmatic radiotherapy is commonly used for stage I-II Testicular Seminoma (TS). Treatment can impact body image (BI), sexual functioning (SF) and quality of life. Unfortunately sexual functioning is often underestimated and prospective data are limited.
To prospectively evaluate treatment outcome, side effects, BI and SF in patients after orchiectomy and radiotherapy for TS.
Questionnaires on BI and SF were sent to 238 patients. The questionnaire prior to radiotherapy (baseline) was returned by 155 patients; 127 returned the second after 3 months, 114 completed the questionnaire after 6 months.
Median age was 36 years (range 18-70), median follow-up was 66 months (range 2-146). Seven patients had disease relapse with no relapses within the radiation field. During irradiation 73% experienced nausea, 29% reported fatigue. After orchiectomy 61% found their body had changed, 49% expressed concerns about fertility.
Experiencing difficulties with sexual contacts (p=0.002), having concerns about undressing in the presence of others (p=0.03) and fertility concerns (p<0.001) correlated negatively with age.
Six months after radiotherapy the quality of erections was significantly decreased compared to prior radiotherapy (p=0.006). The number of sexually active patients remained stable (90%). Sexual satisfaction, importance of sex, quantity of spontaneous erections, difficulty of getting or maintaining an erection and sexual interest did not significantly change (all p>0.05). After 6 months 46% expressed that cancer treatment negatively had influenced their sexual life. This correlated with sexual interest, -functioning and -satisfaction (all p<0.001).
Disease and treatment caused concerns about fertility, changes in body image and negatively influenced sexual life. A significant decrease in the quality of erections was reported, but no decrease in sexually active patients was found. Sexual functioning is very important in this young patient population. These data can help when discussing sexuality in patients with TS.