Sexual function after treatment for sacrococcygeal teratoma during childhood

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.

The Female Sexual Function Index (FSFI), the International Index of Erectile Function (IIEF) and the Body Image Questionnaire (BIQ) were sent to patients (≥18years) treated for SCT in the Dutch pediatric surgical centers after 1970.

Forty-five of 76 patients returned the questionnaires; 28 women (median age 27. 3years, range 18. 3-41. 0) and seven men (median age 22. 0years, 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).

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.

Journal of pediatric surgery. 2015 Sep 25 [Epub ahead of print]

Marijke E B Kremer, Joep P M Derikx, Andrea Peeters, Moniek M Ter Kuile, Robertine van Baren, Hugo A Heij, Marc H W A Wijnen, René M H Wijnen, David C van der Zee, L W Ernest van Heurn

Department of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands. , Department of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands. , Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, Maastricht, the Netherlands. , Department of Psychosomatic Gynecology and Sexology, Leiden University Medical Center, Leiden, the Netherlands. , Department of Pediatric Surgery, University Medical Center Groningen, Groningen, the Netherlands. , Pediatric Surgical Center of Amsterdam (Emma Children's Hospital AMC and VU Medical Center), Amsterdam, the Netherlands. , Department of Pediatric, Radboud University Medical Center, Nijmegen, the Netherlands. , Department of Pediatric Surgery, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands. , Department of Pediatric Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands. , Department of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.  

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