South Tyneside and Sunderland NHS Foundation Trust, Sunderland Royal Hospital, Sunderland, United Kingdom.
School of Sport, Exercise and Health Science, Loughborough University, Loughborough, United Kingdom.
PLoS One. 2022 Sep 22;17(9):e0274914. doi: 10.1371/journal.pone.0274914. eCollection 2022.
Penile cancer is a rare but debilitating condition, which often requires aggressive treatment. Partial penectomy is considered as a treatment option when a sufficient portion of the penile shaft can be maintained to preserve functionality. This systematic review, which followed the PRIMSA guidelines, aimed to evaluate the effects of partial penectomy for penile cancer on sexual function-the maintenance of which is often a priority in patient groups-and to identify potential factors which may moderate these effects. A systematic search of PubMed, The Cochrane Library, and Open Grey as well as MEDLINE, CINAHL and Open Dissertations via EBSCOhost was conducted from inception through to 24th March, 2022. Studies were required to include adults aged ≥18 years who had undergone partial penectomy for the treatment of penile cancer, with a quantitative measure of sexual function available pre- and post-surgery. Four eligible articles were identified for inclusion in this review, three of which reported a decrease in sexual function pre- to post-surgery across all domains of the International Index of Erectile Function (IIEF) questionnaire (erectile function, orgasmic function, sexual desire, intercourse satisfaction and overall satisfaction). Conversely, one study reported an increase in sexual function across IIEF domains, except for orgasmic function, which decreased, pre- to post-surgery. Greater penile length was associated with higher post-operative sexual function, whilst increasing age and higher anxiety levels were associated with lower post-operative sexual function levels in one study. Despite the overall drop in sexual function, many patients were still able to maintain satisfactory sex lives following partial penectomy. Given the limited research in this area and small sample sizes across studies, additional well-controlled investigations are warranted to provide further evidence on the effects of partial penectomy for penile cancer on sexual function.
阴茎癌是一种罕见但使人虚弱的疾病，通常需要积极治疗。当阴茎干能够维持足够的部分以保持功能时，部分阴茎切除术被认为是一种治疗选择。本系统评价遵循 PRIMSA 指南，旨在评估部分阴茎切除术治疗阴茎癌对性功能的影响——保持性功能通常是患者群体的首要任务，并确定可能调节这些影响的潜在因素。通过 EBSCOhost 对 PubMed、The Cochrane Library 和 Open Grey 以及 MEDLINE、CINAHL 和 Open Dissertations 进行了系统搜索，从开始到 2022 年 3 月 24 日进行。研究需要包括年龄≥18 岁的成年人，他们因治疗阴茎癌而接受了部分阴茎切除术，并提供了手术前后性功能的定量测量。本综述共纳入了 4 篇符合条件的文章，其中 3 篇报告了所有国际勃起功能指数 (IIEF) 问卷领域的性功能（勃起功能、性高潮功能、性欲、性交满意度和总体满意度）在手术前后都有所下降。相反，一项研究报告了 IIEF 各领域的性功能增加，除了性高潮功能，手术前后性高潮功能下降。阴茎长度越大与术后性功能越高相关，而在一项研究中，年龄越大和焦虑水平越高与术后性功能水平越低相关。尽管性功能总体下降，但许多患者在接受部分阴茎切除术后仍能够维持满意的性生活。鉴于该领域的研究有限，且研究间的样本量较小，需要进行更多的良好对照研究，以提供更多关于部分阴茎切除术治疗阴茎癌对性功能影响的证据。
