Prospective survey of sexual function among patients with clinically localized prostate cancer referred for definitive radiotherapy and the impact of radiotherapy on sexual function

The purpose of this study is to assess sexual function among patients with clinically localized prostate cancer referred for radiotherapy and to prospectively evaluate the effect of radiotherapy on sexual function, using the Brief Sexual Function Inventory (BSFI). A descriptive study, approved by the local research ethics committee, was prospectively conducted. At baseline, patients were asked to complete a self-administered BSFI, along with other questionnaires describing their clinical condition. Patients with normal erection at baseline were asked to complete a follow-up BSFI at 6, 12, and 24 months postradiotherapy. The collected data was analyzed using the SAS software. The study accrued a total of 117 eligible patients. The mean age was 66 years. Forty-two patients (35.9%) were considered to have erectile dysfunction (ED) at baseline. They were older and more likely on one or more medications affecting potency, compared with those with normal erectile function. They had a consistently lower mean score for all the five domains of BSFI and considered sexual activity less important. Of the 75 patients reporting normal erectile function at baseline, 61 completed a follow-up BSFI questionnaire. Among the 61 patients, 52 underwent radiotherapy with external beam radiotherapy or brachytherapy. Mean scores for all the BSFI domains declined after radiotherapy, suggesting that radiotherapy adversely affected not only erectile function but also other aspects of sexual function including sexual drive and ejaculation. Among the patients with clinically localized prostate cancer referred for radiotherapy, sexual dysfunction was prevalent with 35.9% reporting ED at presentation. Radiotherapy adversely affected all aspects of sexual function.