Beji Dr. Sami, Nolsøe Dr. Alexander B, Jensen Dr. Christian F, Østergren Peter B, Sønksen Jens, Bisbjerg Rasmus, Jakobsen Henrik, Fode Mikkel

(88) PREVALENCE AND PREDICTING FACTORS FOR COMMONLY NEGLECTED SEXUAL SIDE EFFECTS TO LOW-DOSE RATE BRACHYTHERAPY FOR PROSTATE CANCER

  • Urology
  • Reproductive Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health
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Abstract Objectives To investigate orgasmic dysfunction, urinary incontinence during sexual activity (UIS), changes in penile morphology, and sensory disturbances in the penis following Low-dose Rate Brachytherapy (LDR-B) for prostate cancer. Methods Questionnaire-based study in patients who underwent LDR-B at Herlev Hospital from March 2010 through February 2020. The questionnaire included the International Index of Erectile Function (IIEF) and a series of questions on orgasm, UIS, changes in penile morphology, and sensory disturbances in the penis Results Overall, 178 patients responded to the questionnaire. The median age was 70 years (51 to 83 years), and the median time since LDR-B was 93 months (21 to 141 months). Overall, 142 (80%) were sexually active and 126 (70.8%) had erectile dysfunction (ED). Of the sexually active patients, 8 (5.6%) reported anejaculation and 7 (4.9%) reported anorgasmia. Another 67 (46.9%) had decreased orgasmic intensity, while 69 (49.3%) reported an increased time to orgasm. Twenty-six patients (18.3%) had experienced orgasm associated pain with a median visual analog pain score of 2. Considering overlap 44 patients (31.0%) had an unchanged orgasmic function. Six (3.3%) patients had experienced UIS at least a few times. Penile length loss was reported by 45 patients (25.2%). Seventeen (9.6%) patients reported an altered curvature of their penis and 9 (5%) reported that they had experience painful erection. Thirty-three patients (18.5%) had experienced decreased sensitivity in the penis. On multivariate analyses ED was the only independent risk factor for altered perception of orgasm (OR of 6.6, p<0.0001), orgasmic pain (OR 5.5, p=0.008), and penile shortening (OR 4.2, p<0.0056). No independent risk factors were identified for UIS or sensory penile disturbances. Conclusions Orgasmic dysfunction, changes in penile morphology, and sensory disturbances in the penis are common side effects of LDR-B for prostate cancer. Meanwhile, UIS is only experienced by a small minority. Conflicts of Interest None

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