Neglected side effects to curative prostate cancer treatments

In this narrative review we summarize neglected side effects of curative intended treatment for prostate cancer. They include climacturia, arousal incontinence (AI), orgasmic disturbances such as altered orgasmic sensation, anorgasmia, and orgasm-associated pain (dysorgasmia), ejaculatory dysfunctio...

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Bibliographic Details
Published in:International journal of impotence research 2021-05, Vol.33 (4), p.428-438
Main Authors: Nolsøe, Alexander B., Jensen, Christian Fuglesang S., Østergren, Peter B., Fode, Mikkel
Format: Article
Language:English
Subjects:
692/699/2768/515
692/700/784
Cancer
Cancer surgery
Cancer therapies
Care and treatment
Erectile dysfunction
Erectile Dysfunction - etiology
Humans
Male
Medicine
Medicine & Public Health
Mens health
Orgasm
Pain
Penis
Prostate cancer
Prostatectomy - adverse effects
Prostatic Neoplasms - surgery
Prostatic Neoplasms - therapy
Quality of Life
Reproductive Medicine
Review Article
Risk factors
rology
Sexual disorders
Side effects
Urinary incontinence
Urological surgery
Urology
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Summary:In this narrative review we summarize neglected side effects of curative intended treatment for prostate cancer. They include climacturia, arousal incontinence (AI), orgasmic disturbances such as altered orgasmic sensation, anorgasmia, and orgasm-associated pain (dysorgasmia), ejaculatory dysfunction, and morphological penile alterations in the form of shortening and deformity. Even though they have not received as much interest as erectile dysfunction (ED) or urinary incontinence, these side effects have been shown to negatively impact patient’s quality of life. They are common and rates of climacturia after radical prostatectomy (RP) range from 20% and 45%, less after external beam radiation therapy (EBRT). Decreased orgasmic sensation ranges from 3.9% to 60% after RP and between 36–57% after EBRT. Dysorgasmia ranges from 9.5–15% for both RP and EBRT. Anejculation after EBRT ranges from 11–71% and rates of penile shortening are reported between 0 and 100%. There are no internationally validated questionnaires that adequately asses these side effects. This is necessary if we are to align patient and partner expectations properly and consequently manage them optimally. Neglected side effects should be discussed with patients and their partners preoperatively, as they are associated with bother and may lead to patient’s avoiding sexual activity.
ISSN:0955-9930
1476-5489
DOI:10.1038/s41443-020-00386-4