Sexual functioning after treatment for early stage prostate cancer

With recent advances in prostate cancer detection and treatment, the vast majority of men with newly diagnosed prostate cancer can expect long-term survival. Therefore, quality of life issues become important in selecting the appropriate therapeutic approach. Sexual function can be adversely affected by the only available curative treatment modalities: radical prostatectomy, external beam radiation therapy and interstitial brachytherapy. The pathophysiology of erectile dysfunction after surgery and radiation therapy are reviewed. Reports documenting rates of erectile dysfunction after treatment among men potent prior to treatment are described. Management options for patients who become impotent after surgery or radiation therapy are outlined. Future avenues of research to decrease the rates of potency loss with modern treatment techniques are suggested.