The development of erectile dysfunction in men treated for prostate cancer

Purpose: Erectile dysfunction is a common side effect in men treated for pr ostate cancer. Previously published studies document the incidence of erect ile dysfunction in men treated for prostate cancer to be between 20% and 88 %. To our knowledge a prospective evaluation focused on the development of erectile dysfunction in men treated for prostate cancer has not elucidated components of its chronology or risk factors. Materials and Methods: A centralized prospective database of 2,956 patients diagnosed with prostate cancer at a single institution was studied in rega rd to pretreatment and posttreatment erectile dysfunction. Of these 2,956 p atients 802 had sufficient information regarding erectile function and comp rise our study population. Factors analyzed in regard to treatment and erec tile dysfunction include treatment modality, that is radical prostatectomy, external beam radiation therapy and watchful waiting, and ethnicity, patie nt age, clinical stage and tumor histological grade. Results: No significant difference was noted in the posttreatment erectile function between patients treated with radical prostatectomy or external be am radiation (10% versus 15%). Patients selecting watchful waiting had the lowest risk of erectile dysfunction. Clinical stage and race were significa nt predictors for the development of erectile dysfunction in the watchful w aiting and external beam radiation treatment groups. Conclusions: Erectile dysfunction develops in greater than 80% of patients treated for prostate cancer. External beam radiation has the same risk for erectile dysfunction as radical prostatectomy.