Improving the preservation of erectile function after external beam radiation therapy for prostate cancer

Effects of Preoperative Radiotherapy for Primary Resectable Rectal Adenocarcinoma on Male Sexual and Urinary Function

“…Erectile dysfunction has been reported in 45 percent of patients after 9 to 18 months of follow-up and in 77 percent after 4 to 5 years of follow-up. 22 It is postulated that this is related to damage to the nervi erigentes. 23 Frykholm et al 24 reported on six patients who developed a late lumbosacral plexopathy after preoperative radiotherapy for rectal adenocarcinoma.…”

Estimating the risk of long-term erectile, urinary and bowel symptoms resulting from prostate cancer treatment

“…Following radiation, ED results from vascular damage secondary to radiation (as opposed to direct trauma from surgery). As a result, ED generally worsens with time because of radiationinduced scarring 32,45 but may be more likely (than ED after RP) to respond to treatment with sildenafil (and other phosphodiesterase inhibitors). 61,102 The risk following radiation treatments also depends upon the radiation dose and how the radiation is delivered.…”

Long-term Symptoms after External Beam Radiation Therapy for Prostate Cancer with Three or Four Fields

“…In a dose-escalating phase I study, the likelihood of chronic urinary bladder symptoms increased considerably when more than 65 Gy was given to at least 30% of the urinary bladder volume (1). No statistically signi cant correlation was found between the prescribed dose and the risk of gastrointestinal toxicity, but a rectal volume (anatomically) exceeding 100 cm 3 was associated with an increased risk of bowel toxicity (1). Clearly, treatment techniques in uence the risk of longterm distressful symptoms after radiotherapy.…”

“…No statistically signi cant differences were noted for bladder or sexual function between the groups. In a before-and-after study it was observed that there were fewer men with erectile dysfunction when a multileaf collimator was used than when a collimator was not used (3). In a dose-escalating phase I study, the likelihood of chronic urinary bladder symptoms increased considerably when more than 65 Gy was given to at least 30% of the urinary bladder volume (1).…”