Impact of Partial Penectomy and Glansectomy on Couples' Sexual Function

To evaluate the sexual function of couples after surgeries to treat penile cancer.

Patients who underwent partial penectomy or glansectomy at a cancer center, between April 2014 and January 2024, and their partners were interviewed only once, at least six months after surgery, through individually conducted interviews. We used a semi-structured questionnaire, the Six-Item Female Sexual Function Index Scoring (FSFI-6) questionnaire to assess feminine sexual function and the Erection Hardness Score (EHS) and The International Index of Erectile Function-5 (IIEF-5) questionnaire to evaluate erectile function.

Fourteen couples were included in this study. Five patients underwent glansectomy and nine underwent partial penectomy. All of male patients remained sexually active post-procedure. Of the ten who completed the IIEF-5, five (50%) experienced mild erectile dysfunction. Among partners, twelve (85.7%) continued sexual activity. Of the ten partners who completed the FSFI-6, five (50%) had sexual dysfunction. The size of the penile stump was not correlated with satisfaction of the couples. Four (28.6%) patients adopted adaptive strategies, as engaging in sexual activity in a dark environment and use of silicone penile substitutes. All participants expressed dissatisfaction with the medical information provided by their doctors regarding sexuality after penile surgery.

Many couples described sexual dysfunctions after PC surgeries. However, the majority of couples reported maintaining an active sexual life and the majority of the partners reported achieving orgasm. Unfortunately, counseling by healthcare professionals of these couples about sexual health after surgery to treat PC is inadequate.