Erectile Aid Use By Men Treated For Localized Prostate Cancer

Editor's Choice
Main Category: Prostate / Prostate Cancer
Also Included In: Erectile Dysfunction / Premature Ejaculation;  Cancer / Oncology;  Urology / Nephrology
Article Date: 10 Aug 2009 - 0:00 PDT

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UroToday.com - A UCLA single-institution study in the online edition of the Journal of Urology reports on the use of erectile aid (EA) following treatment for localized prostate cancer (CaP). Participants with a diagnosis of CaP were prospectively recruited between 1999 and 2003. Clinical and pathological data was abstracted and HRQOL (Health Related Quality of Life) outcomes were prospectively abstracted at baseline and 1, 2, 4, 8, 12, 18, 24, 30, 36, 42 and 48 months.

The SF-36 which combines 8 individual domains into physical and mental composite summary scores was used to study general HRQOL. Disease specific QOL was assessed using the AUASI and UCLA-PCI (capturing urinary, sexual and bowel function and bother scores).

A total of 425 men participated in the study and at 24 and 48 months 75% and 60% completed questionnaires, respectively. Treatment consisted of radical prostatectomy (RP) in 275 men, external beam radiotherapy (EBRT) in 70, and brachytherapy in 80 patients. Bilateral nerve sparing RP was performed in 81%. A total of 237 of the 425 men (56%) used an EA in the post-treatment period. Men using an EA were younger, more likely to be employed, and to have chosen RP compared with a radiation modality when compared to patients not using an EA.

The CaP tended to have lower PSA and Gleason scores in those using an EA. Regarding HRQOL scores and EA usage, men using an EA had a higher mean physical composite score at baseline than those without EA use, but mental composite scores were comparable in men using vs. not using EA. There was less urinary bother and better sexual function at baseline in men using EA.

There was no significant difference between groups regarding urinary control, bowel function or sexual bother. Patients treated with EBRT were less likely to use EA than those treated with RP. Patients with moderate or severe sexual bother and those with one or more co-morbid conditions were more likely to use EA.

The baseline sexual function was significantly better in men with RP than either form of radiation therapy, but function at 2 and 4 years was comparable in the 3 groups. Sexual bother was comparable in the 3 groups at baseline but worsened significantly with time in men treated with RP.

Bergman J, Gore JL, Penson DF, Kwan L, Litwin MS
J Urol. 2009 Aug;182(2):649-54.
doi:10.1016/j.juro.2009.04.001

Written by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS

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