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Roth B, Moukhtar Hammad MA, Sanford DI, Piper M, Barham DW, Yafi FA, Jenkins LC. The relationship between hematologic malignancies on male hypogonadism: a scoping review. Sex Med Rev 2024; 12:449-457. [PMID: 38515317 DOI: 10.1093/sxmrev/qeae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 03/23/2024]
Abstract
INTRODUCTION The associated symptoms of hypogonadism have been reported in patients with various types of cancer. However, the prevalence and significance of hypogonadism among certain hematologic malignancies have not been completely summarized in recent literature. OBJECTIVE In this review we aimed to examine the current literature on hypogonadism in patients with hematologic malignancies, with emphasis on leukemias, lymphomas, and multiple myeloma (MM). METHODS This review included relevant studies published before July 2023 that were retrieved through a search of PubMed using the keywords "hematologic cancer," "hematologic malignancy," blood cancer," "leukemia," "lymphoma," "hypogonadism," "multiple myeloma," and "testosterone." RESULTS The search yielded 214 studies, of which 21 met the inclusion criteria. Commonly reported findings were that patients who had received hematopoietic stem cell therapy for acute lymphoblastic leukemia and acute myelogenous leukemia as children had laboratory-confirmed hypogonadism as adults. However, the impact of these diseases on hypogonadal symptoms was variable in these studies.Studies reporting on lymphoma and hypogonadism had mixed results, with some studies finding that the degree of cytotoxic chemotherapy was associated with hypogonadism, while others showed no correlation. Regardless, multiple studies found that hypogonadism secondary to lymphoma treatment and symptoms of hypogonadism had no apparent association.The most comprehensive assessment of the frequency of hypogonadism in an MM cohort found that 74% of 561 MM patients were classified as hypogonadal compared to 33% of patients in a control population. Testosterone supplementation was found to lower interleukin-6 levels, which could potentially help manage some of the adverse effects of MM, including decreased bone mineral density. CONCLUSION There is a relationship between hematologic malignancies and hypogonadism, which is likely multifactorial. In this review we established that the most plausible factors are related to the secondary effects of gonadotoxic treatments and/or systemic inflammatory responses to the diseases.
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Affiliation(s)
- Bradley Roth
- Department of Urology, University of California, Irvine, Irvine 92697, CA, United States
| | | | - Daniel I Sanford
- Department of Urology, Brown University, Providence 02905, RI, United States
| | - Molly Piper
- Penn State College of Medicine, Hershey 17033, PA, United States
| | - David W Barham
- Brooke Army Medical Center AHP, Fort Sam Houston, San Antonio 78234, TX, United States
| | - Faysal A Yafi
- Department of Urology, University of California, Irvine, Irvine 92697, CA, United States
| | - Lawrence C Jenkins
- Department of Urology, University of California, Irvine, Irvine 92697, CA, United States
- Department of Urology, New Orleans, Tulane University, New Orleans 70112, LA, United States
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Wang SK, Lee MC, Hung CL, Chen HH, Liao CC, Chiu YL. Association between hypertriglyceridemic waist phenotype and hypogonadism in Taiwanese adult men. PLoS One 2022; 17:e0265629. [PMID: 35320301 PMCID: PMC8942218 DOI: 10.1371/journal.pone.0265629] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 03/04/2022] [Indexed: 11/19/2022] Open
Abstract
Background Aging-related hypogonadism in men is related to the deterioration of overall health. Those with this disease rarely receive treatment. The hypertriglyceridemic waist (HTGW) phenotype is a tool for predicting abnormalities of cardiovascular metabolism. However, the relationship between the HTGW phenotype and hypogonadism remains undetermined. This study aimed to determine the association between HTGW phenotype and hypogonadism in different age groups. Methods Data of this cross-sectional study were obtained from MJ Health Screening Center in Taiwan from 2007 to 2016. The HTGW phenotype was divided into four categories based on whether the waist circumference (WC) and triglyceride levels were normal. WC of <90 cm and triglyceride level of <150 mg/dL were defined as normal. Hypogonadism was defined as a testosterone level of <300 ng/dL. Results Overall, 6442 male participants were divided into three age groups: <50, 50–64, and ≥65 years (n = 4135, 1958, and 349; age groups 1, 2, and 3, respectively). The overall prevalence of hypogonadism was 10.6%. In group 1, participants with HTGW (odds ratio, 1.98; 95% confidence interval (CI), 1.354–2.896) had a higher risk of hypogonadism than those with normal WC and normal triglyceride levels after adjustment for body mass index and fasting blood glucose level. In group 2, participants with HTGW (odds ratio, 1.873; 95% CI, 1.099–3.193) had an increased risk of hypogonadism after adjustment for body mass index, fasting blood glucose level, Cholesterol levels, high-density lipoprotein (HDL) levels, low-density lipoprptein (LDL) levels and smoking status. However, no relationship was observed between HTGW phenotype and hypogonadism in group 3. Conclusion HTGW phenotype was highly associated with hypogonadism in Taiwanese adult men. More attention should be paid to men aged <50 years with HTGW.
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Affiliation(s)
- Sheng-Kuang Wang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
- Medical Administrative Department, Taichung Army Forces General Hospital, Taichung, Taiwan
| | - Meng-Chih Lee
- Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
- College of Management, Chaoyang University of Technology, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Chia-Lien Hung
- Department of Medical Education and Research, Taichung Armed Forces General Hospital, Taichung, Taiwan
| | - Hsin-Hung Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asia University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Law, Providence University, Taichung, Taiwan
- Chung Sheng clinic, Nantou, Taiwan
| | - Chun-Cheng Liao
- Department of Medical Education and Research, Taichung Armed Forces General Hospital, Taichung, Taiwan
- Department of Family Medicine, Taichung Armed Forces General Hospital, Taichung, Taiwan
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
- * E-mail: (CCL); (YLC)
| | - Yu-Lung Chiu
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- * E-mail: (CCL); (YLC)
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Abstract
The epidemiology of male hypogonadism has been understudied. Of the known causes of endogenous androgen deficiency, only Klinefelter syndrome is common with a likely population prevalence of greater than 5:10,000 men (possibly as high as 10-25:10,000). Mild traumatic injury might also be a common cause of androgen deficiency (prevalence 5-10:10,000 men), but large, long-term studies must be completed to confirm this prevalence estimation that might be too high. The classic causes of male androgen deficiency-hyperprolactinemia, pituitary macroadenoma, endogenous Cushing syndrome, and iron overload syndrome-are rare (prevalence < 10,000 men).
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Affiliation(s)
- Arthi Thirumalai
- Department of Medicine, University of Washington School of Medicine, Box 356420, 1959 Northeast Pacific Avenue, Seattle, WA 98195, USA
| | - Bradley D Anawalt
- Department of Medicine, University of Washington School of Medicine, Box 356420, 1959 Northeast Pacific Avenue, Seattle, WA 98195, USA.
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Zhang H, Yang H, Bandyopadhyay S, Milano MT, Fung C, Messing EM, Chen Y. Increased risk of high-grade prostate cancer among testicular cancer survivors. PLoS One 2022; 17:e0263573. [PMID: 35157714 PMCID: PMC8843166 DOI: 10.1371/journal.pone.0263573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 01/22/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Testicular cancer survivors (TCS) have an increased risk of additional cancers, including prostate cancer. Our understanding of the natural history of prostate cancer in testicular cancer survivors is very limited due to its rare incidence. Methods Using the Surveillance, Epidemiology, and End Results (SEER) Registry from 1978 to 2011, we identified 282 TCS with subsequent prostate cancer and examined the tumor grade and clinical outcomes in contrast to men with primary prostate cancer in the general population. Results TCS with a subsequent prostate cancer diagnosis were more likely to be diagnosed at a younger age than men with primary prostate cancer (65.2% vs. 37.6% for age ≤65, 34.8% vs. 62.4% for age >65, p<0.001) and were more likely to have grade III/IV tumors (46.2% vs. 37.0%, p<0.002). Longer latency between testicular and prostate cancer diagnoses was associated with a higher risk of grade III/IV (p<0.001) cancer. Despite the increased risk for high-grade tumors, 10-year prostate cancer-specific survival and overall survival were not significantly different between TCS and men with primary prostate cancer. Based on the available information in SEER, we found that prior history of radiotherapy for testicular cancer had no impact on tumor grade or survival outcomes. Conclusions Prostate cancer in TCS was more likely to be diagnosed at a younger age and with higher grades. Risks of grade III/IV disease increased with longer latency between testicular and prostate cancer diagnoses. Radiotherapy for testicular cancer did not appear to have a significant impact on the outcome of subsequent prostate cancer.
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Affiliation(s)
- Hong Zhang
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY, United States of America
- * E-mail:
| | - Hongmei Yang
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Sanjukta Bandyopadhyay
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Michael T. Milano
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Chunkit Fung
- Division of Hematology and Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Edward M. Messing
- Department of Urology, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Yuhchyau Chen
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY, United States of America
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Kerie S, Workineh Y, Kasa AS, Ayalew E, Menberu M. Erectile dysfunction among testicular cancer survivors: A systematic review and meta-analysis. Heliyon 2021; 7:e07479. [PMID: 34286139 PMCID: PMC8278428 DOI: 10.1016/j.heliyon.2021.e07479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/10/2021] [Accepted: 07/01/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Erectile dysfunction is one of the common complications of testicular cancer with a prevalence of 11.3%-84%. It has devastating effects on men and their partner's quality of life, sexual satisfaction, and sexual experience. The findings of the previous studies on this matter were uneven and inconsistent. Therefore, this systematic review and meta-analysis is conducted to acquire a more recent and comprehensive result. METHODS AND MATERIALS PubMed, Scopus, Goggle scholar, Science Direct, African Index Medicus, African Journal online, EMBASE, and Cochrane Library databases were searched. All necessary data were extracted using a standardized data extraction format. Data were analyzed using STATA 14 statistical software. A heterogeneity of studies was assessed using the I2 statistics. Publication bias was checked by using a funnel plot and Egger's regression test. A random-effects model was computed to estimate the pooled prevalence of erectile dysfunction. RESULT Fourteen full-text studies were included in this systematic review and meta-analysis. The pooled prevalence of erectile dysfunction among testicular cancer survivors was found to be 34.60% (95% CI: 25.89, 43.30 [I2 = 95.9% p = 0.000]). Study design subgroup analysis indicated that the pooled prevalence of erectile dysfunction was 50.02% (95% CI: 22.78, 77.28% [I2 = 96.1 p = 0.000]), and 27.36% (95% CI: 19.23, 34.48% [I2 = 91.6, P = 0.000]) in the case-control and cohort studies, respectively. Likewise, the level of erectile dysfunction was varied based on ED erectile dysfunction measuring tools and testicular cancer treatment modalities. CONCLUSION In this study erectile dysfunction was found to be a highly prevalent complication in testicular cancer survivors. It had also causes of heterogeneity in terms of treatment modalities, study designs, and measuring tools. Therefore prevention of this complication should be the concern of the responsible bodies.
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Affiliation(s)
- Sitotaw Kerie
- Department of Adult Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yinager Workineh
- Department of Child Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ayele Semachew Kasa
- Department of Adult Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Emiru Ayalew
- Department of Adult Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Melak Menberu
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Liu YJ, Shen XB, Yu N, Shang XJ, Gu YQ, Zuo LD, Xiong CL, Ye Z, Zhou YZ. Prevalence of late-onset hypogonadism among middle-aged and elderly males in China: results from a national survey. Asian J Androl 2021; 23:170-177. [PMID: 33154202 PMCID: PMC7991815 DOI: 10.4103/aja.aja_59_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
This study aimed to propose an operational definition of late-onset hypogonadism (LOH) that incorporates both clinical symptoms and serum testosterone measurements to evaluate the prevalence of LOH in aging males in China. A population-based sample of 6296 men aged 40 years-79 years old was enrolled from six representative provinces in China. Serum total testosterone (TT), sex hormone-binding globulin (SHBG), and luteinizing hormone (LH) were measured and free testosterone (cFT) was calculated. The Aging Males' Symptoms (AMS) scale was used to evaluate the LOH symptoms. Finally, 5078 men were included in this analysis. The TT levels did not decrease with age (P = 0.59), and had no relationship with AMS symptoms (P = 0.87 for AMS total score, P = 0.74 for ≥ 3 sexual symptoms). The cFT levels decreased significantly with age (P < 0.01) and showed a negative association with the presence of ≥ 3 sexual symptoms (P = 0.03). The overall estimated prevalence of LOH was 7.8% (395/5078) if a cFT level <210 pmol l-1 combined with the presence of ≥ 3 sexual symptoms was used as the criterion of LOH. Among them, 26.1% (103/395) and 73.9% (292/395) had primary and secondary hypogonadism, respectively. After adjustment for confounding factors, primary and secondary hypogonadism was positively related to age and comorbidities. Body mass index was an independent risk factor for secondary hypogonadism. The results suggest that the AMS total score is not an appropriate indicator for decreased testosterone, and that the cFT level is more reliable than TT for LOH diagnosis. Secondary hypogonadism is the most common form of LOH.
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Affiliation(s)
- Yi-Jun Liu
- School of Public Health, Zunyi Medical University, Zunyi 563000, China
| | - Xu-Bo Shen
- School of Public Health, Zunyi Medical University, Zunyi 563000, China
| | - Na Yu
- Scientific Research Center, The Third Affiliated Hospital of Guang Dong Medical University (Long Jiang Hospital of Shunde District Foshan City), Foshan 528318, China
| | - Xue-Jun Shang
- Department of Andrology, Eastern Theater General Hospital, Nanjing 210002, China
| | - Yi-Qun Gu
- Institute of Science and Technology, National Research Institute for Family Planning, Beijing 100081, China
| | - Lian-Dong Zuo
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510632, China
| | - Cheng-Liang Xiong
- Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zhen Ye
- Department of Urology and Andrology, Wuhan Tongji Reproductive Medicine Hospital, Wuhan 430013, China
| | - Yuan-Zhong Zhou
- School of Public Health, Zunyi Medical University, Zunyi 563000, China
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Yao Y, Zhang C, Han B, Tang Y, Xiong Y, Wang S. [Shikonin induces cell death by inhibiting glycolysis in human testicular cancer I-10 and seminoma TCAM-2 cells]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2020; 40:1288-1294. [PMID: 32990238 DOI: 10.12122/j.issn.1673-4254.2020.09.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To investigate the pattern of shikonin-induced cell death in testicular cancer cell I-10 and seminoma TCAM-2 cells and explore the possible mechanism in light of mitochondrial function and glycolysis. METHODS I-10 cells treated with 0, 1.2, 1.4 and 1.6 μmol/L shikonin and TCAM-2 cells treated with 0, 0.5, 1 and 1.5 μmol/L shikonin were examined for mitochondrial membrane potential and production of reactive oxygen species (ROS) using JC-1 kit and ROS kit, respectively. The levels of intracellular lactic acid in the cells were detected using a lactic acid kit. The inhibitory effect of shikonin on the proliferation of the cells was assessed with MTT assay. The death patterns of the cells were observed by transmission electron microscopy, and annexin V-FITC/PI double staining was used to detect cell apoptosis. Western blotting was used to detect the relative expression levels of the apoptotic proteins Bax, Bcl-2, and cleaved caspase-3, the autophagy- related protein LC3B and glycolysis- related proteins PKM2, GLUT1 and HK2. RESULTS MTT assay showed that shikonin significantly inhibited the proliferation of I-10 and TCAM-2 cells in a time- and dose-dependent manner (P < 0.05). The IC50 values of shikonin in I-10 cells at 24, 48, and 72 h were 1.8, 1.36 and 1.16 μmol/L, as compared with 2.37, 0.8 and 0.41 μmol/L in TCAM-2 cells, respectively. Shikonin treatment significantly reduced mitochondrial membrane potential, increased ROS levels and lower the level of lactic acid in both I-10 and TCAM-2 cells (P < 0.05). Transmission electron microscopy and annexin V-FITC/PI double staining demonstrated that shikonin induced apoptosis and excessive autophagy in I-10 and TCAM-2 cells (P < 0.05). In both I-10 and TCAM cells, shikonin treatment significantly down- regulated the expressions of Bax, Bcl-2, cleaved caspase-3, PKM2, GLUT1 and HK2, and up-regulated the expression of autophagy-related protein LC3B (P < 0.05). CONCLUSIONS Shikonin can inhibit the proliferation, induce apoptosis and increase autophagy in both I-10 and TCAM-2 cells probably by affecting energy metabolism of the cells.
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Affiliation(s)
- Yue Yao
- Department of Urology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China
| | - Chong Zhang
- Department of Urology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China
| | - Bing Han
- Department of Urology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China
| | - Yurui Tang
- Department of Urology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China
| | - Yanjun Xiong
- Department of Urology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China
| | - Sheng Wang
- Department of Urology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China
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Okada K, Fujita K, Fukuhara S, Kiuchi H, Uemura M, Imamura R, Nonomura N. Erectile Dysfunction in Germ Cell Tumor Survivors. World J Mens Health 2020; 39:533-540. [PMID: 32777864 PMCID: PMC8255390 DOI: 10.5534/wjmh.200042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/30/2020] [Accepted: 06/16/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose Germ cell tumors (GCTs) are the most common malignant neoplasms in adolescents and young adults, and most patients with these tumors can be completely cured. Therefore, maintaining quality of life (QOL) is important. Erectile dysfunction (ED) is one factor that reduces the QOL of GCT survivors. We aimed to clarify the relationship between ED and age, follow-up period, serum levels of hormones, and treatment methods for GCT survivors. Materials and Methods We evaluated ED using the Sexual Health Inventory for Men questionnaire (SHIM) and measured serum levels of hormones in survivors after GCT treatment. The relationships between the SHIM score responses and age, serum levels of hormones, follow-up period, and treatment methods were assessed using a logistic analysis. Results Fifty-two GCT survivors were enrolled and 46 survivors completed the SHIM. The median age, follow-up period, and SHIM score were 38 years, 35 months, and 18, respectively. Regarding the SHIM scores, 85% had scores <22 and 46% had scores <17. The percentage of SHIM scores <17 was 69% in patients with under 2 years of follow-up. It significantly improved to 33% in patients with over 2 years of follow-up. The multivariate analysis identified the follow-up period as an independent factor for SHIM scores <17. Age, serum levels of hormone, and treatment method were not significant factors for SHIM scores <17. Conclusions Improvement of SHIM score can be expected after GCT treatment regardless of age, serum levels of hormone, and treatment method.
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Affiliation(s)
- Koichi Okada
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kazutoshi Fujita
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan.
| | - Shinichiro Fukuhara
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hiroshi Kiuchi
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Motohide Uemura
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Ryoichi Imamura
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Norio Nonomura
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
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Pallotti F, Petrozzi A, Cargnelutti F, Radicioni AF, Lenzi A, Paoli D, Lombardo F. Long-Term Follow Up of the Erectile Function of Testicular Cancer Survivors. Front Endocrinol (Lausanne) 2019; 10:196. [PMID: 31001201 PMCID: PMC6453999 DOI: 10.3389/fendo.2019.00196] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 03/08/2019] [Indexed: 12/16/2022] Open
Abstract
The diagnosis of testicular cancer (TC) can have a considerable and persistent impact on a patient's sexuality, especially given its location. The high prevalence of TC in young adults, and the good prognosis, explain the great interest in sexual dysfunction and its influence on post-treatment quality of life. The aim of this study was to evaluate the impact of the diagnosis and treatments (inguinal orchiectomy and chemotherapy) on sex life. For this purpose, we recruited 241 TC patients attending the Laboratory of Seminology-Sperm Bank "Loredana Gandini" for sperm cryopreservation (mean age 31.3 ± 6.9 years) and 223 cancer-free healthy men who were undergoing andrological screening (mean age 32.0 ± 7.7 years). The IIEF-15 questionnaire was administered at the baseline (post-orchiectomy, pre-chemotherapy-T0) and at 6 (T1), 12 (T2), 18 (T3), 24 (T4), 48 months (T5) and >5 years (T6, median 96 months) after chemotherapy to all patients, to evaluate the following domains: erectile function (EF), orgasmic function (OF), sexual desire (SD), intercourse satisfaction (IS) and overall satisfaction (OS). A subgroup of patients also underwent blood sex hormone analysis for further correlations with IIEF scores. At the baseline, 37.7% of patients had erectile dysfunction (EF score <26) and all IIEF domains except OF showed significantly lower scores than in controls (p < 0.001). Long-term follow-up revealed persistently lower scores in TC survivors than in controls for EF, SD, IS, and OS. Furthermore, most IIEF domains did not improve significantly in TC patients during the duration of the follow-up, with the exception of EF, which showed a significant improvement from T2. Finally, no significant correlation was found between hormone levels (gonadotropin and testosterone) and IIEF-15 scores. In conclusion, TC and its treatment have a significant effect on sexuality. The absence of a clear correlation with biochemical hypogonadism suggests that this may to a large extent be due to the surgical procedure itself, or to the psychological impact of a cancer diagnosis.
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Affiliation(s)
- Francesco Pallotti
- Laboratory of Seminology–Sperm Bank Loredana Gandini, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Alessandra Petrozzi
- Laboratory of Seminology–Sperm Bank Loredana Gandini, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Francesco Cargnelutti
- Laboratory of Seminology–Sperm Bank Loredana Gandini, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | | | - Andrea Lenzi
- Laboratory of Seminology–Sperm Bank Loredana Gandini, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Donatella Paoli
- Laboratory of Seminology–Sperm Bank Loredana Gandini, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
- *Correspondence: Donatella Paoli
| | - Francesco Lombardo
- Laboratory of Seminology–Sperm Bank Loredana Gandini, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
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Hisasue SI. Editorial Comment to High prevalence of hypogonadism determined by serum free testosterone level in Japanese testicular cancer survivors. Int J Urol 2018; 25:462-463. [DOI: 10.1111/iju.13586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Shin-ichi Hisasue
- Department of Urology; Chiba-Nishi General Hospital; Matsudo City; Chiba Japan
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