Prostatic irradiation-induced sexual dysfunction: A review and multidisciplinary guide to management in the radical radiotherapy era (Part II on Urological Management)

Rep Pract Oncol Radiother. 2020 Jul-Aug;25(4):619-624. doi: 10.1016/j.rpor.2020.03.011. Epub 2020 May 6.

Abstract

Prostate cancer is the most common malignancy in men and the second leading cause of cancer-related death in men. Radiotherapy is a curative option that is administered via external beam radiation, brachytherapy, or in combination. Sexual dysfunction is a common toxicity following radiotherapy, similar to men undergoing radical prostatectomy, but the etiology is different. The pathophysiology of radiation-induced sexual dysfunction is multi-factorial, and the toxicity is a major cause of impaired quality of life among long-term prostate cancer survivors. Management of a patient's sexual function during and after radiotherapy requires multidisciplinary coordination of care between radiation oncology, urology, psychiatry, pharmacy, and dermatology. This review provides a framework for clinicians to better understand prostatic radiotherapy-induced sexual dysfunction diagnosis, evaluation, and a patient-centered approach to toxicity preventive strategies and management.

Keywords: Ejaculatory dysfunction; Erectile dysfunction; Intracavernosal Injections; Orgasmic dysfunction; PDE-5i; Penile Vibratory stimulation; Penile prosthesis; Prostate cancer; Radiation therapy; Sexual Toxicities; Vacuum erection device.

Publication types

  • Review