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Sexual function and satisfaction in men after laser treatment for penile carcinoma
Örebro University, Department of Clinical Medicine.
Örebro University, Department of Clinical Medicine.
2004 (English)In: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 172, no 2, p. 648-651Article in journal (Refereed) Published
Abstract [en]

Purpose:

We evaluate sexual function, sexual satisfaction and cosmetic results after laser treatment of penile carcinoma.

Materials and Methods:

A total of 67 patients were treated at our clinic for penile cancer using combined carbon dioxide and neodymium:YAG lasers from 1986 to 2000. At the time of this study 58 men, with a mean age of 64 years were alive, of whom 46 (79%) agreed to participate in a structured face-to-face interview addressing sexual function, sexual satisfaction and cosmetic results. The length of time that had elapsed since treatment ranged from 6 months to 15 years (median 3 years).

Results:

Of 40 patients (87%) who had been sexually active before treatment 30 (75%) had resumed activities at the time of the interview. Unaltered erectile function after treatment was reported by 33 patients (72%), 10 patients (22%) reported decreased function and 3 (6%) reported improved function. Of the 46 patients 23 (50%) were satisfied/very satisfied with their sexual life. After treatment only 3 of 30 (10%) of the evaluable men had dyspareunia. The cosmetic results were considered satisfying/very satisfying by 36 (78%) men.

Conclusions:

Laser treatment of localized penile carcinoma preserves the penis and generally provides satisfactory sexual function and cosmetic results.

Place, publisher, year, edition, pages
2004. Vol. 172, no 2, p. 648-651
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-3151DOI: 10.1097/01.ju.0000132891.68094.87OAI: oai:DiVA.org:oru-3151DiVA, id: diva2:137165
Available from: 2004-05-19 Created: 2004-05-19 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Clinical aspect of laser treatment of lichen sclerosus and squamous cell carcinoma of the penis
Open this publication in new window or tab >>Clinical aspect of laser treatment of lichen sclerosus and squamous cell carcinoma of the penis
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of these studies was to investigate the efficacy, complications and the long term results after laser treatment of lichen sclerosus et atrophicus and of squamous cell carcinoma of the penis.

Patients and Methods: Paper I: In a prospective study from 1985-1991, 62 men with histologically verified lichen sclerosus et atrophicus were given carbon dioxide (CO2) laser treatment following the failure of local corticosteroid treatment. The study was subsequently updated at a median follow-up time of 14 years.

Paper II-IV: Sixty-seven men aged 26 to 87 (mean 60 years) with newly diagnosed penile carcinoma were included in a prospective study. The patients were treated by a new combined laser method (CO2 and Nd:YAG) between 1986 and 2000. The median follow-up time was 42 months (range 12-186 months). All patients could be assessed for local recurrence, progression and survival at the end of 2001. Forty-six patients agreed to participate in face-to-face interviews addressing sexual activity, sexual function/dysfunction, satisfaction and cosmetic results.

Results: Paper I: The laser treatment was successful in 47 patients (76%) with no local symptoms at a mean follow-up of 30 months. Fifty-three of the 62 men were alive when the update was carried out in February 2004, and we were able to get in contact with 50 of them. Forty of these patients (80%) had no local symptoms or visible lesion. We found concomitant squamous cell carcinoma of the penis in two patients and two further patients had died from anal cancer.

Paper II-IV: Local recurrences appeared in 13 patients (19%) at a median follow up of 42 months, and 10 of these patients were successfully retreated with laser treatment. Two patients died from penile carcinoma. The disease-specific 5-years survival rate was 95%. Concomitant lichen sclerosus was found in 11 patients. All patients younger than 75 years reported that they were sexually active before the treatment, and 80% of them had resumed their sexual activity after the treatment. Ten patients (22%) reported decreased erectile function after the treatment, while 33 patients (72%) reported unaltered erectile function. The cosmetic result was regarded as satisfying or very satisfying in 78% of the patients.

Conclusion: Carbon dioxide laser treatment is an efficient treatment for lichen sclerosus et atrophicus with excellent long-term results, and the side effects are few. One disadvantages of the treatment is a slow postoperative healing process. Combined CO2 and Nd:YAG laser treatment is effective for treatment of the primary tumour in patients with localized penile carcinoma. It can be safely carried out with good local tumour control and highly satisfactory results with respect to cosmetic aspects and sexual function.

Place, publisher, year, edition, pages
Örebro: Örebro universitetsbibliotek, 2004. p. 51
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 3
Keyword
Medicin, Penile diseases, lichens, penile neoplasms, lasers, carcinoma, squamous cell carcinoma, sexual function, sexaul satisfaction, medicin
National Category
Dermatology and Venereal Diseases
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-72 (URN)91-7668-393-1 (ISBN)
Public defence
2004-06-10, Wilandersalen, Universitetssjukhuset, Örebro, 13:00 (English)
Opponent
Supervisors
Available from: 2004-05-19 Created: 2004-05-19 Last updated: 2017-10-18Bibliographically approved
2. Penile carcinoma: from first symptom to sexual function and life satisfaction following organ-sparing laser treatment
Open this publication in new window or tab >>Penile carcinoma: from first symptom to sexual function and life satisfaction following organ-sparing laser treatment
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to describe how patients with penile carcinoma experienced their symptoms, treatment seeking and the impact of the diagnosis and treatment on sexual function, sexual activity and life satisfaction. The thesis contains two studies of patients treated with organ-sparing laser therapy, a retrospective study (Papers II and III) of 46 patients treated between 1986-2000 and a prospective study (Papers I and IV) of 50 patients between 2005 and 2009 and additional 34 partners. In both studies face-to-face interviews were used with a structured questionnaire; and self-assessment instruments IIEF-5, LiSat-11, and HADS. An ad hoc comparator population of men aged 34–74 years from a nationally representative investigation of sexual life and life satisfaction in Swedes was chosen for some of the questions concerning sexuality and life satisfaction. We found a delay of more than 6 months in 37% of the patients in the retrospective study and 65% of the patients in the prospective study. The single most important reason for patients’ delay was embarrassment. Nine patients had a doctors’ delay of more than 3 months from first special visit until diagnosis. Eight of these patients consulted dermatologists and were subjected to repeated biopsies, leaving premalignant results (I, II). All patients younger than 75 years (34/46) in the retrospective study reported that they were sexual active before treatment, 80% of these had resumed their activity by the time of the interview. Furthermore, except for satisfaction with somatic health, similar—or even higher—proportions of patients than comparators were satisfied with life as a whole and with other domains of life including satisfaction with sexual life (III). We found that 21/29 couples were sexually active with intercourse before treatment and 17 couples resumed their activity. Two items differed markedly from the comparators; considerably fewer patients were satisfied with their somatic health, and satisfaction with sexual life (at 12 months follow-up). Couples with an active partner-related sexuality at 12 months follow-up, reported coherence in high satisfaction with life as a whole (IV).In conclusion, patients with penile carcinoma delay for a long time after identifying symptoms before seeking contact with the health care system. This delay is mainly caused by embarrassment in describing the symptom to health care personnel and deficient knowledge about the disease. Organ- sparing technique offers good, satisfying cosmetic results and the possibility of maintaining sexual activity and function to a great extent.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2012. p. 101
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 73
Keyword
Penile carcinoma, sexuality, life satisfaction, treatment-seeking, sexual function, Sexual dysfunction, delay, organ-sparing
National Category
Medical and Health Sciences Cancer and Oncology Urology and Nephrology
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-24417 (URN)978-91-7668-891-5 (ISBN)
Public defence
2012-10-19, Wilandersalen, Universitetssjukhuset, Örebro, 13:00 (Swedish)
Opponent
Supervisors
Note

Varierande stavning av förnamnet Elisabet förekommer.

Available from: 2012-08-24 Created: 2012-08-15 Last updated: 2017-10-17Bibliographically approved

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