Prostate Cancer Diagnosis Raises Erectile Dysfunction Risk

CHICAGO—A prostate cancer (PCa) diagnosis, by itself, has a negative psychological impact on men that may result in erectile dysfunction, investigators reported at the World Meeting on Sexual Medicine.

Brian T. Helfand, MD, and collaborators at Northwestern University's Feinberg School of Medicine in Chicago, studied 85 men undergoing a single 12-core prostate biopsy. They filled out International Index of Erectile Function (IIEF), American Urological Association Symptom Index (AUA-SI), and Quality of Life (QoL) questionnaires.

Pre- and post-biopsy IIEF scores did not differ significantly in the study population overall, but the subgroup of 23 men found to have PCa on biopsy had a significantly greater adverse change in post-biopsy IIEF scores compared with the subgroup of 62 men who did not have PCa found (mean change -10.1 vs. -1.1).

The men with PCa experienced significant adverse changes in all IIEF domains, including erectile function (mean change -4.3 vs. 10.8). Multivariate analysis showed that men had threefold increased risk of a significant negative change in erectile function, defined as a greater than five-point drop in total ILEF score, after being told of a position result on biopsy.

The investigators observed no significant differences in AUA-SI or QoL scores in the overall cohort or in the subgroups.

“In conclusion,” Dr. Helfand told attendees, “we found that prostate cancer diagnosis does not influence lower urinary tract symptoms following a prostate biopsy. However, the diagnosis in itself does … influence erectile function.”

Most clinicians evaluate a man's erectile function following a prostate biopsy, he added, but the study's findings suggest that erectile function should be evaluated prior to biopsy because a positive diagnosis may influence the results of the evaluation.

The meeting is cosponsored by the International Society for Sexual Medicine and the Sexual Medicine Society of North America.

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