Sexual function after treatment for sacrococcygeal teratoma during childhood

Abstract

Background Children treated for sacrococcygeal teratoma (SCT) may suffer from sexual dysfunction later in life because of the extended pelvic surgery performed, however, structured evaluations have not been performed yet. Methods The Female Sexual Function Index (FSFI), the International Index of Erectile Function (IIEF) and the Body Image Questionnaire (BIQ) were sent to patients (≥ 18 years) treated for SCT in the Dutch pediatric surgical centers after 1970. Results Forty-five of 76 patients returned the questionnaires; 28 women (median age 27.3 years, range 18.3-41.0) and seven men (median age 22.0 years, range 19.1-36.5) were eligible for analysis. The FSFI and IIEF results were compared to healthy controls. Female patients scored significantly lower on the desire (p = 0.014), arousal (p = 0.013) and lubrication domain (p = 0.019). FSFI total-scores of female patients were significantly lower compared to controls [median 30.5 (IQR 28.6-31.4) vs. median 32.4 (IQR 30.6-33.45) p ≤ 0.001] but were above the threshold value for sexual dysfunction. Males reported normal erectile function and penetration ability with normal ejaculation. Females had significant lower BIQ results compared to males; BIQ-cosmesis scores were moderately correlated to the FSFI-desire score (r = - 0.37, p = 0.028). Conclusion SCT resection in girls may result in diminished sexual function at adult age with worse self-perceived body image. The possibility of sexual complaints should be integrated in the surveillance strategies for these patients.