Sexual function after surgical treatment for penile cancer: Which organ-sparing approach gives the best results?

Authors

  • Omid Sedigh Urology Departement University of Turin - Italy "Città della salute e della scienza"
  • Marco Falcone Urology Departement University of Turin - Italy "Città della salute e della scienza"
  • Carlo Ceruti Urology Departement University of Turin - Italy "Città della salute e della scienza"
  • Massimiliano Timpano Urology Departement University of Turin - Italy "Città della salute e della scienza"
  • Mirko Preto Urology Departement University of Turin - Italy "Città della salute e della scienza"
  • Marco Oderda Urology Departement University of Turin - Italy "Città della salute e della scienza"
  • Franklin Kuehhas Medica School of Vienna
  • Mattia Sibona Urology Departement University of Turin - Italy "Città della salute e della scienza"
  • Arianna Gillo Urology Departement University of Turin - Italy "Città della salute e della scienza"
  • Paolo Gontero Urology Departement University of Turin - Italy "Città della salute e della scienza"
  • Luigi Rolle Urology Departement University of Turin - Italy "Città della salute e della scienza"
  • Bruno Frea

DOI:

https://doi.org/10.5489/cuaj.2801

Keywords:

penile cancer, wide local excision, urethralglanduloplasty, organ-sparing surgery, sexual function

Abstract

Introduction: We compared the postoperative sexual function of patients who underwent wide local excision (WLE) and glansectomy with urethral glanduloplasty for penile cancer.

Methods: We retrospectively reviewed clinical data of 41 patients affected by superficial, localized penile cancer (≤cT2a) between 2006 and 2013. Patients with severe erectile dysfunction and not interested in resuming an active sexual life were selected for penile partial amputation. Patients with preoperative satisfying erectile function and concerned about the preservation of their sexual potency were scheduled for WLE (Group A) or glansectomy with urethral glanduloplasty (Group B). Sexual function was assessed with the International Index of Erectile Function (IIEF) questionnaire and the Sex Encounter Profile (SEP). At 1 year, patients were asked to complete the questionnaires again and were questioned about their genital sensibility and ejaculatory reflex persistence. Postoperative complications were reported according to the Clavien-Dindo classification. Statistical analysis was performed by two-tailed test: Student t-test and chi-square.

Results: Among the 41 patients enrolled, 12 underwent WLE (29.2%), 23 glansectomy with urethral glanduloplasty (56%) and 6 with penile partial amputation (14.6%). A decrease in postoperative IIEF was recorded in both groups, but was statistically significant only in Group B (p = 0.003). As for the SEP, while no significant changes were recorded postoperatively in Group A, a marked reduction was reported for Group B, with a statistically significant decrease in the possibility of achieving penetrative intercourse (p = 0.006) and in the perceived satisfaction during sexual activity (p = 0.004).

Conclusions: WLE lead to better sexual outcomes and less postoperative complications as compared to glansectomy with urethral glanduloplasty.

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Author Biographies

Omid Sedigh, Urology Departement University of Turin - Italy "Città della salute e della scienza"

MD Urology Departement

Marco Falcone, Urology Departement University of Turin - Italy "Città della salute e della scienza"

MD Urology Departement

Carlo Ceruti, Urology Departement University of Turin - Italy "Città della salute e della scienza"

MD Urology Departement

Massimiliano Timpano, Urology Departement University of Turin - Italy "Città della salute e della scienza"

MD Urology Departement

Mirko Preto, Urology Departement University of Turin - Italy "Città della salute e della scienza"

MD Urology Departement

Marco Oderda, Urology Departement University of Turin - Italy "Città della salute e della scienza"

MD PhD Urology Departement

Franklin Kuehhas, Medica School of Vienna

MD

Mattia Sibona, Urology Departement University of Turin - Italy "Città della salute e della scienza"

MD

Arianna Gillo, Urology Departement University of Turin - Italy "Città della salute e della scienza"

MD Urology Clinic

Paolo Gontero, Urology Departement University of Turin - Italy "Città della salute e della scienza"

MD , Associate Professor

Luigi Rolle, Urology Departement University of Turin - Italy "Città della salute e della scienza"

MD PhD

Bruno Frea

MD Full Professor

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Published

2015-07-17

How to Cite

Sedigh, O., Falcone, M., Ceruti, C., Timpano, M., Preto, M., Oderda, M., Kuehhas, F., Sibona, M., Gillo, A., Gontero, P., Rolle, L., & Frea, B. (2015). Sexual function after surgical treatment for penile cancer: Which organ-sparing approach gives the best results?. Canadian Urological Association Journal, 9(7-8), E423–7. https://doi.org/10.5489/cuaj.2801

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Section

Original Research