Prevalence of erectile dysfunction in male survivors of cancer: a systematic review and meta-analysis of cross-sectional studies

Abstract

Background: Sexual function is a fundamental aspect of health, well being and quality of life. In oncological male patients sexuality and erectile dysfunction (ED) can be compromise by psychological, pharmacological or physical components. Aim: We conducted a meta-analysis to estimate the prevalence of ED in all types of cancer and identify characteristics associated with ED in cancer survivors. Design and Setting: Systematic review and meta-analysis of cross-sectional studies. Method: Random effects models were used to pool the prevalence of ED as absolute estimates at three different stages (i.e., healthy, at diagnosis, and after treatment stages). A univariate meta-analysis (MA) regression including the three-level group variable as the only independent variable was used to assess the difference of prevalence of ED across the three groups. Further MA were conducted for studies involving patients at diagnosis and after treatment. Graphical comparisons of the prevalence of ED across these two stages of cancer treatment were given by a classic forest plot. Results: We included 43 studies with a total of 19,329 participants. Overall the pooled data of the included studies showed an ED prevalence of 40.72% (95%CI: 31.80-50.29) in cancer patients, with prevalence of 28.60% (95%CI: 12.10%-53.83%) at time of diagnosis and 42.70% (95%CI: 32.97%-53.03%) after treatment, across cancer locations. Conclusion: ED is particularly high in oncologic patients and may be influenced by neurovascular damage associated with treatment, hormonal therapy systemic chemo- or radiation therapy, as well as by psychological factors such as depression, anxiety, low self-esteem or issues with body image.

Phloretin in Benign Prostate Hyperplasia and Prostate Cancer: A Contemporary Systematic Review

“…Judging from the immune-modulatory mechanism of phloretin in BPH, retrograde ejaculation would be less than with α-blockers. Sexual function and the potential side effects regarding this would be of great importance when developing drugs for BPH and PCa, since the population suffering from BPH and PCa largely overlapped with the population suffering from erectile dysfunction [ 82 , 83 ]. Although 5α-reductase enzyme was not lowered by phloretin, a decreased level of DHT was noted [ 11 ].…”

Opioid-Induced Sexual Dysfunction in Cancer Patients

“…The incidence of ED in the general population ranges from 10–15% in men aged 40–49 to 50–70% in men aged 60–79 years [ 29 , 30 ] Risk factors include age, cardiovascular diseases, diabetes, obesity, smoking, and depression [ 31 , 32 ]. The incidence of ED in the cancer patient population may be around 29% at the time of diagnosis and 43% after treatment, but it is strongly dependent on the type of cancer and may be up to 80–90% for prostate, anus or colorectal cancers [ 33 ]. The effect of opioids on male erection is not well known.…”

“…On average, they affect more than half of patients, but they vary widely depending on specific cancers. In female breast cancer, it may be around 66% [ 48 ], 65–90% in colorectal cancers [ 33 , 48 ], 78% in gynecological cancers [ 48 ] and up to 80% in prostate cancer [ 49 ].…”

Ejaculation Disorders in Male Patients with Cancer: A Systematic Review and Meta-Analysis of Prevalence

“…The final studies included a total of 10,057 participants. The most affected sites were testis (43 studies), rectum (15), prostate (7), bladder (3) and colon (3). Full descriptive characteristics can be found in table 1.…”

“…In turn, the worsening of sexual function is associated with anxiety, low mood and reductions in personal and couple's quality of life. 2 Recently, a prevalence of 40.72% of erectile dysfunction was reported in cancer survivors, with a multimodal etiology including a variety of psychological and physical factors, 3 which is vastly higher than a recent study of a representative sample of U.S. adults that have estimated erectile dysfunction at 11.3%. 4 Other sexual problems associated with cancer and related treatments are ejaculatory disorders.…”