Premature Ejaculation and Erectile Dysfunction in Iranian Prostate Cancer Patients

Abstract

Background: To investigate the prevalence of premature ejaculation (PE) and erectile dysfunction (ED) in a sample of patients with prostate cancer and to determine the utility of the previously suggested cutoffs of the Premature Ejaculation Diagnostic Tool (PEDT) for the diagnosis of PE and that of International Index of Erectile Function (IIEF-5) for ED. Materials and Methods: A total of 1,202 men with prostate cancer were invited from urology clinics at the universities of Iran, Tehran, Qazvin, Ahvaz, Guilan and Tabriz. Clinical characteristics were collected through medical records. PE and ED diagnoses were made by trained urologists. In addition to the clinical diagnoses, PE and ED were measured through self-report using the PEDT and the IIEF-5. Questionnaire cutoff scores were determined using receiver operating characteristic (ROC) curves and confirmed by predictive ability using logistic regression. Results: The prevalence of PE was 63.7% and that of ED was 66.2%. Prevalences of PE decreased and that of ED increased with advanced TNM stages. According to ROC, the suggested cutoff for the PEDT to diagnose a PE was ≥ 11 (sensitivity=0.988, 1-specificity=0.084, and predictive ability=0.914) and ≤ 17 for the IIEF-5 (sensitivity=0.966, 1-specificity=0.031, and predictive ability=0.967). Conclusions: Prevalence of sexual problems was high in prostate cancer patients in Iran, therefore oncologists should take into account these potential problems when deciding on treatment modalities.

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“…All five items are rated on a five-point Likert scale (ranging from 1 to 5), and higher scores indicate poorer erectile function. The IIEF has been translated into Persian with satisfactory reliability (item separation reliability = 0.99) [29] and good known-group validity (i.e., the Persian IIEF can distinguish male patients with sexual problems from those without) [30].…”

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“…In a recent meta-analysis, across 145 studies, diabetic men were 3.5 times more likely to experience ED than non-diabetic men (Kouidrat et al, 2017). Others have found associations between ED and kidney disease (Navaneethan et al, 2010) as well as prostate cancer (Lin, Burri, & Pakpour, 2016).…”

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“…al. showed a prevalence of 63.7% of PE in 1202 men diagnosed with prostate cancer in Iran [14]. PE is the most common ejaculatory disorder and may present with first sexual encounter or be acquired later in life [15].…”