Sexual Function in Patients with Metastatic Midgut Carcinoid Tumours

Background: Sexual dysfunction is a poorly studied aspect of quality of life in patients with midgut carcinoid tumours. We investigated whether carcinoid patients experience sexual problems. Methods: Patients with metastatic midgut carcinoid tumours filled in a validated questionnaire for sexual dysfunction. The prevalence of dysfunction on the subscales arousal, erection, lubrication, orgasm and dyspareunia was compared to a Dutch reference population. Plasma concentration of gonadal hormones, tryptophan and urinary 5-hydroxyindolacetic acid concentrations were measured. Results: 43 patients were studied, 27 men and 16 women. Sexual dysfunction was present in 29.6% of men and 6.3% of women. The prevalence of sexual dysfunction on the different subscales did not differ from the reference population. Patients with a sexual dysfunction had, compared to those without a sexual dysfunction, a longer duration of disease, 95.3 months (range 5.4-314.5) versus 18.6 months (range 0.6-167.9) (p = 0.024), lower plasma tryptophan concentration (+/- SD) of 31.5 +/- 16.1 and 48.9 +/- 14.5 mu mol/l (p = 0.031), and more often used interferon-alpha, 50% of patients versus 10.5% of patients (p = 0.044). Conclusion: Patients with metastatic midgut carcinoid tumours do not experience sexual problems more often than a reference population. Male patients with sexual dysfunction are characterised by more long-standing disease and lower tryptophan concentration. Copyright (c) 2008 S. Karger AG, Base

Sexual dysfunction in young women with breast cancer

<p>The objective of this study was to determine the prevalence of sexual dysfunction in young women with breast cancer in the Netherlands, and to assess the relationship between sexual dysfunction, treatment methods and treatment-related complaints. Also, the interest among women with breast cancer in receiving care for sexual dysfunction was determined.</p><p>Data on sexual functioning were collected through an internet questionnaire. Respondents were included if they had been diagnosed with breast cancer within the past 6 years and were currently 45 years of age or younger. Results were compared with a representative sample of the general Dutch population</p><p>Of the women who were still undergoing treatment, 64 % had a sexual dysfunction. In women who had completed treatment, this was 45 %. All assessed dysfunctions were more common among these young women with breast cancer in comparison with women in the Dutch population. Particularly, early menopause and hormone therapy caused long-term occurence of genital arousal disorder. Radical mastectomy caused long-term occurrence of female orgasmic disorder, and early menopause dyspareunia. Half of the women reported that the topic "changes in sexual functioning" had been brought up during treatment, mostly on the initiative of the health professional. Six out of 10 women with a sexual dysfunction who felt a need for care did not consult a health professional.</p><p>Sexual dysfunctions are highly prevalent among young women with breast cancer. This appears to improve after treatment has been completed, but women are far from recovered. The initiative to discuss sexuality should lie with the health professional. Including sexuality within treatment guidelines will prevent women with breast cancer from being deprived of care.</p>

Male sexual function and lower urinary tract symptoms after laparoscopic total mesorectal excision

The original publication can be found at www.springerlink.comBackground and aims The aim of this study was to investigate sexual function and the presence of lower urinary tract symptoms (LUTS) in male patients with rectal cancer following short-term radiotherapy and laparoscopic total mesorectal excision (LTME) by physical and psychological measurements. Materials and methods Sexual function and LUTS were assessed by the use of questionnaires [International Index of Erectile Function (IIEF), International Prostate Symptom Score]. Sexual function was further assessed by the use of pharmaco duplex ultrasonography of the cavernous arterial blood flow and nocturnal penile tumescence and rigidity monitoring (NPTR). All investigations were performed prior to the start of preoperative radiotherapy and 15 months after surgery. Results Nine patients (mean age 60 years) participated. Erectile function was maintained in 71% and ejaculation function in 89%. Compared with pre-operative scores on the IIEF, a significant deterioration in intercourse satisfaction was seen following radiotherapy and LTME (7.9 vs 10.3, p = 0.042), but overall satisfaction remained unchanged (8.0 vs 7.0, p = 0.246). NPTR parameters (duration of erectile episodes, duration of tip rigidity ≥60%) decreased following radiotherapy and LTME. Patients reported a deterioration in micturition frequency (2.0 vs 1.0, p = 0.034) and quality of life due to urinary symptoms (8.0 vs 1.8, p = 0.018). Conclusion Based on these first preliminary findings, data suggest that 15 months after short-term radiotherapy and LTME in men with rectal cancer, objectively assessed sexual dysfunction was considerable, but overall sexual satisfaction had not changed.S. O. Breukink, M. F. van Driel, J. P. E. N. Pierie, C. Dobbins, T. Wiggers and W. J. H. J. Meijerin