(077) ASSESSMENT OF SEXUAL FUNCTION IN PATIENTS UNDERGOING PARTIAL PENECTOMY
Authors: Borges Cabral Junior J , Mikaelly Da Silva Gomes V , Antônio De Souza Filho C , Augusto Irineu Aguiar Ramos L , Ariel Pires Cavalcanti Zeca A , De Albuquerque Pereira De Oliveira R , Conceição De Souza R , Henrique Sales Lins T , Arão Cohen Foinquinos R , Jose Cardoso Cavalcante F , Dubourcq De Barros F 
Published: December 2024

Abstract

Introduction
Malignant neoplasms of the penis are a rare condition in most of the world, especially in least developed countries. With poor genital hygiene conditions as the most prevalent etiological factor, it is a illness that can affect men of all age groups, with the diagnosis occurring in individuals under 60 years of age in around 60% of cases, therefore in a sexually active age group. Despite organ-sparing treatment modalities, anatomical disfigurement of the penis and consequent impacts on quality of life and sexual function may be inevitable, making this subject an important topic of discussion within the scientific community.

Objective
Assess the impact of partial penectomy on sexual function and satisfaction in penile cancer patients.

Methods
The study analyzed patients who underwent partial penectomy at two tertiary hospitals in northeastern Brazil in the years 2022 and 2023. Patients completed the International Index of Erectile Function (IIEF-5) after the procedure, which consists of four items assessing erectile dysfunction (ED) and one item on satisfaction with sexual intercourse. ED severity was categorized based on total score in: severe (1-7), moderate (8-16), and mild (17-21).

Results
Nineteen patients who underwent partial penectomy were included, with a mean age of 57 years, ranging from 43 to 78 years. In the sample, 21% of pacients underwent bilateral lymphadenectomy. One patient received systemic treatment and radiotherapy prior to surgical intervention. There was no difference in the surgical technique used, and the extent of penile segment removed varied based on clinical manifestations and staging of each case. Approximately 79% of patients experienced some degree of ED postoperatively, with 47% showing moderate dysfunction and 53% severe dysfunction. Those with severe dysfunction had an average age of 60 years, did not have others comorbidities, and didn’t undergo systemic therapy or radiotherapy. Common complaints among patients with severe ED included changes in their relationships with partners post-procedure, with the lowest scores in sexual satisfaction with intercourse. Around 21% of patients made no attempts at sexual activity following the surgical procedure. No systemic complications occurred postoperatively, but some patients reported resolved local wound complications during follow-up. There were no deaths related to the disease or to others causes during the follow-up period.

Conclusions
Despite methodological limitations of the study, the impact of diagnosis and surgical treatment on sexual function of penile cancer patients was evident. However, some satisfaction can be maintained post-partial penectomy, especially with partner support. Assessments of sexual results after partial penectomy can be useful in therapeutic planning and preoperative counseling, to preserve the patient’s sexual function and satisfaction.

Disclosure
No.