Erectile Aid Use by Men Treated for Localized Prostate Cancer

Purpose: We evaluated associations between demographic and clinical characteristics, quality of life outcome measures and erectile aids in men treated for localized prostate cancer. Materials and Methods: Patients had clinically localized prostate cancer, were not using erectile aids at baseline and chose treatment with radical prostatectomy (275), external beam radiotherapy (70) or brachytherapy (80). Patient characteristics and health related quality of life outcomes were prospectively assessed at baseline and at regular intervals up to 48 months after treatment. Outcomes were assessed with SF-36 (TM), the American Urological Association symptom index and UCLA-PCI. We categorized use of a phosphodiesterase type 5 inhibitor, urethral alprostadil suppositories, penile injection therapy or a vacuum erection device after treatment as erectile aid use. We created a multivariate model examining baseline demographic, clinical and health related quality of life covariates associated with erectile aid use. Results: Of the 425 patients 237 (56%) used an erectile aid at some point during the posttreatment period. In our multivariate model patients treated with external beam radiation were less likely to use an aid (OR 0.34, 95% CI 0.16-0.69) and men with significant sexual bother (OR 2.68, 95% CI 1.37-5.23), or with 1 or more comorbidities (OR 1.80, 95% CI 1.08-2.93) were more likely to use an aid. Patient demographic characteristics were not associated with erectile aids. Conclusions: After treatment for localized prostate cancer more than half of men use erectile aids, especially when they are significantly bothered by dysfunction. This is most pronounced after radical prostatectomy and in men with significant comorbidity.