The Impact of Testicular Prosthesis on Cancer Patients' Intimacy and Quality of Sex Life.

Introduction Post-orchiectomy testicular prosthesis (TP) implantation is offered to patients to minimize psychological distress. Sexual dysfunction, negative body image perception, and fertility outcomes are well addressed in the literature; however, little is known about the impact of TP on sexual life. Methods This is a retrospective, single-center cohort study conducted at Hôpital Universitaire de Bruxelles. Patients with TP completed a questionnaire exploring body image perception, reasons for TP acceptance, overall satisfaction, and both short- and long-term impacts on their sexual life and quality of life. Statistical analyses using the Chi-square and Wilcoxon tests were performed to correlate TP satisfaction with patients' characteristics, sexual dysfunction, fertility, and interpersonal or professional stability. Results Sixty patients were included between 2000 and 2021, with a median follow-up of 6.2 years (range: 3.4-11.7). The mean age at orchiectomy was 32 years (range: 17-49). During this period, 10 (17%) patients required testosterone supplementation, 10 (18%) developed depression, 17 (31%) changed their profession, 9 (16%) separated from their partner, and 15 (30%) fathered at least one child. Weight gain was observed in 40 (67%) patients. Forty-eight (80%) patients were satisfied with their TP. However, 24 (40%) felt it was too high, 31 (52%) too firm, and 12 (20%) too large. There was no significant impact on overall sexual performance (p > 0.05), although erectile dysfunction was significantly associated with dissatisfaction with the prosthesis (p = 0.01). Conclusions Overall TP satisfaction was high, with no negative impact on patients' sexual life or quality of life. Patients who were dissatisfied with the TP were predominantly those who experienced erectile dysfunction.