Cancer of the penis or scrotum is rare, and cancer of the testes is only slightly more com­mon. Still, the sexual problems that result from these diseases are similar to those from prostate cancer. Testicular cancer is most common in men who are in their most pro­ductive years. Research has found that although sexual problems are common after treat­ment for testicular cancer, there is considerable improvement 1 year after diagnosis (van Basten et al., 1999).

In Chapter 5 we discussed testicular cancer, and, although the surgical removal of a testicle (orchiectomy) due to cancer usually does not affect the ability to reproduce (as the remaining testicle produces enough sperm and, usually, adequate testosterone), some men do experience psychological difficulties. This is mainly due to feelings that they have lost part of their manhood or fears about the appearance of their scrotum. The ap­pearance of the scrotum can be helped by inserting a testicular prosthesis that takes the place of the missing testicle. In some rare cases, cancer of the penis may necessitate a partial or total penectomy (pee-NECK-toe-mee). In a total penectomy, the man’s ure­thra is redirected downward to a new opening that is created between the scrotum and anus. Even with a penectomy, some men can have orgasms by stimulating whatever tis­sue is left where the penis was, and the ejaculate leaves the body through the urethra (Schover & Jensen, 1988).