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Treatment-seeking, aspects of sexual activity and life satisfaction in men with laser-treated penile carcinoma
Örebro University, School of Health and Medical Sciences.
Örebro University, School of Health and Medical Sciences.
2008 (English)In: European Urology, ISSN 0302-2838, E-ISSN 1873-7560, Vol. 54, no 3, p. 631-639Article in journal (Refereed) Published
Abstract [en]

ObjectivesThe aims were to assess the initial symptoms of penile carcinoma and patients’ time frame in treatment seeking, and to describe the effect of laser treatment on sexual activity and life satisfaction.Patients and methodsA retrospective face-to-face structured interview study of patients laser treated for localised penile carcinoma at the department of Urology in Örebro, Sweden, during 1986 to 2000. Sixty-seven was treated and 58 of them (mean age, 63 yr; range, 34–90) were alive at the time of this study. Forty-six (79%) agreed to participate.ResultsNinety-six percent of the patients recalled their first symptom of penile carcinoma. Superficial ulceration and fissures were the most common symptoms (39%). Thirty-seven percent delayed seeking treatment for more than 6 mo.The patients had a greater lifetime number of sexual partners and a greater lifetime prevalence of STIs than a Swedish representative comparator population.Some aspects of sexual life, such as manual stimulation/caressing and fellatio, decreased markedly after laser treatment.Patient satisfaction with life as a whole was approximately the same as that of the general population.ConclusionsPatients delayed seeking treatment for a considerable period, despite awareness of the first local symptoms. Men with laser-treated localised penile carcinoma resume their sexual activities to a large extent after the treatment. Except for satisfaction with somatic health, similar—or even higher—proportions of patients than comparators are satisfied with life as a whole and with other domains of life including satisfaction with sexual life.Take Home MessageIn this study of 46 men who received laser treatment for localised penile carcinoma, we found that they resumed their sexual activities to a great extent and coped well with nearly all aspects of life after the treatment.

Place, publisher, year, edition, pages
Amsterdam: Elsevier , 2008. Vol. 54, no 3, p. 631-639
National Category
Medical and Health Sciences Urology and Nephrology
Research subject
Medicine; Surgery esp. Urology Specific
Identifiers
URN: urn:nbn:se:oru:diva-3664DOI: 10.1016/j.eururo.2007.10.028PubMedID: 18788122OAI: oai:DiVA.org:oru-3664DiVA, id: diva2:137962
Available from: 2008-12-17 Created: 2008-12-17 Last updated: 2017-12-14Bibliographically approved
In thesis
1. 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
Keywords
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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Publisher's full textPubMedhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Retrieve&list_uids=18788122&dopt=Citation

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Skeppner, ElisabetAndersson, Swen-Olof

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