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Erectile dysfunction following radical therapy for prostate cancer
1St Mary's Hospital, W2 1NY, London, UK.
Summary
Erectile dysfunction (ED) is a common concern after prostate cancer treatment. Assessment and various treatments, including medication and devices, can help manage ED and improve quality of life for patients.
Area of Science:
- Urology
- Oncology
- Sexual Medicine
Background:
- Increasing early detection of prostate cancer necessitates focus on post-treatment quality of life.
- Erectile dysfunction (ED) is a significant concern following radical prostate cancer therapies.
Purpose of the Study:
- To review the causes and management strategies for erectile dysfunction after prostate cancer treatment.
- To provide an overview of current treatment options for post-prostatectomy and post-radiotherapy ED.
Main Methods:
- Literature review of studies on ED following prostate cancer therapy.
- Analysis of reported efficacy of various ED treatment modalities.
Main Results:
- ED affects approximately one-third of patients post-radiotherapy and 30-70% post-radical prostatectomy.
- Vascular factors, not solely nerve damage, may contribute to ED.
- Sildenafil is effective in 70% of post-radiotherapy ED cases, but only 40-50% post-surgery.
Conclusions:
- Comprehensive assessment for correctable risk factors is crucial for all patients with ED post-prostate cancer treatment.
- Treatment options range from oral medications like sildenafil to alprostadil injections, vacuum devices, and penile implants.
- Management should be individualized to improve patient quality of life.