Incidence of Erectile Dysfunction and Testosterone Deficiency in Testicular Cancer Survivors.

Abstract

Purpose: This project aims to characterize the incidence of men's health disorders, specifically focusing on the incidence of erectile dysfunction (ED) and testosterone deficiency (TD) in a large, nationwide study of Testicular cancer (TC) survivors treated in a centralized healthcare system.

Patients and methods: We conducted a retrospective cohort study of US Veterans diagnosed with TC from 1990 to 2021. These were compared to an age and race-matched control group of US Veterans without a diagnosis of TC. ED and TD were defined by the presence of diagnosis codes or at least a 6-months prescription for medications treating these conditions or both. Time was measured from date of TC diagnosis (for TC patients, and matched TC patient date for the corresponding non-cancer controls). Impact of chemotherapy among TC survivors on ED and TD was evaluated using multivariable Cox regression models.

Results: The cohort included 1754 patients with TC compared to 7117 non-cancer controls, with a mean age at diagnosis of 42 years. TC patients were significantly more likely than controls to experience ED (hazard ratio 2.97, 95% CI 2.68 to 3.28, P < .001) and TD (hazard ratio 6.71, 95% CI 5.78-7.81, P < .001). However, within the TC group, there was no significant difference in the incidence of ED and TD when stratified by receipt of chemotherapy (P = .9 and P = .066, respectively).

Conclusions: Men's health disorders arise commonly in the lives of TC survivors. It is important for treating physicians to identify these and conduct sexual health assessments as part of survivorship care.