PURPOSE: To assess the impact of primary surgery (penile-sparing surgery versus (partial) penectomy), and lymphadenectomy on sexuality and health-related quality of life (HRQOL).
MATERIALS AND METHODS: We invited patients surgically treated for penile cancer in the Netherlands Cancer Institute between 2003 and 2008 (N=147) to complete the International Index of Erectile Function (IIEF-15), the Short Form-36 Health Survey (SF-36), the Impact of Cancer questionnaire (IOCv2), and questions about urinary function. We evaluated the impact of primary surgery type and lymphadenectomy on these outcomes. We also compared the patients' SF-36 scores with those of an age- and sex-matched normative sample from the general Dutch population.
RESULTS: Ninety patients (62%) returned a completed questionnaire. Type and extent of surgery was not associated significantly with most of the study outcomes assessed. However, men who underwent (partial) penectomy reported significantly more problems than those who had had penile-sparing surgery with orgasm (p=0.031;ES=0.54), appearance concerns (p=0.008;(ES)=0.61), life interference (p=0.032;ES=0.49), and urinary function (83% versus 43%, p< 0.0001). Men who underwent lymphadenectomy reported significantly more life interference (p=0.037;ES=0.50). The patient sample scored significantly better than the normative sample on the SF-36 physical component (p=0.044) and bodily pain subscale (p< 0.001).
CONCLUSIONS: Few differences were observed in sexuality and HRQOL as a function of primary surgery and lymphadenectomy. However, (partial) penectomy and lymphadenectomy are associated with more problems with orgasm, body image, life interference and urination. Additional longitudinal studies are warranted to evaluate individual changes over time in these outcomes.
Kieffer JM, Djajadiningrat RS, van Muilekom EA, Graafland NM, Horenblas S, Aaronson NK. Are you the author?
Division of Psychosocial Research and Epidemiology, the Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Urology, the Netherlands Cancer Institute, Amsterdam, the Netherlands.
Reference: J Urol. 2014 Apr 17. pii: S0022-5347(14)03342-4.