Ejaculatory function after radiotherapy for prostate cancer: a systematic review and meta-analysis

Area of Science:

• Oncology
• Urology
• Radiology

Background:

• Limited data exists on the effects of prostate radiation on male ejaculatory function.
• Prostate radiation therapy is a common treatment for prostate cancer.

Purpose of the Study:

• To systematically review and perform a meta-analysis on ejaculatory outcomes in men following prostate radiation.
• To quantify the anejaculation rate, ejaculatory volume (EV), ejaculatory discomfort (EjD), and changes in ejaculatory function scores (EFS) post-radiation.

Main Methods:

• A systematic literature search was conducted across PubMed, Embase, and Web of Science.
• 17 observational studies involving 2156 patients were included.
• Pooled proportions were calculated using inverse variance and random effects models to assess outcomes.

Main Results:

• The pooled proportion of patients experiencing anejaculation was 18% (95% CI, 11-36%).
• A significant reduction in ejaculatory volume (EV) was observed in 85% (95% CI, 81-89%) of patients.
• Ejaculatory discomfort (EjD) affected 24% (95% CI, 16-35%), and five studies reported a decline in ejaculatory function scores (EFS).

Conclusions:

• Prostate radiation therapy can lead to substantial changes in male ejaculatory function, including absence of ejaculation, reduced EV, and EjD.
• It is crucial to counsel patients about these potential adverse effects before treatment initiation.
• Further research may be warranted to explore mitigation strategies for these side effects.