https://doi.org/10.4081/aiua.2022.2.166

Erectile dysfunction following hydrogel injection and hypofractionated radiotherapy for prostate cancer: Our experience in 56 cases

Vol. 94 No. 2 (2022)
Submitted: April 10, 2022
Accepted: April 23, 2022
Published: June 29, 2022
Prostate cancer; Erectile dysfunction; Hypofractionated radiotherapy; Intraprostatic fiducials; Hydrogel injection.
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Authors

Pietro Pepe
piepepe@hotmail.com
Urology Unit, Cannizzaro Hospital, Catania, Italy.
Maria Tamburo
Radiotherapy Unit, Cannizzaro Hospital, Catania, Italy.
Paolo Panella
Urology Unit, Cannizzaro Hospital, Catania, Italy.
Ludovica Pepe
Urology Unit, Cannizzaro Hospital, Catania, Italy.
Giulia Marletta
Radiotherapy Unit, Cannizzaro Hospital, Catania, Italy.
Michele Pennisi
Urology Unit, Cannizzaro Hospital, Catania, Italy.
Francesco Marletta
Radiotherapy Unit, Cannizzaro Hospital, Catania, Italy.

Introduction: The incidence of erectile dysfunction (ED) in men with organ-confined prostate cancer (PCa) submitted to hypofractionated radiotherapy (HRT) has been prospectively evaluated. Materials and methods: From April 2018 to September 2020, 56 patients (median age 70 years) with cT1c PCa were treated by HRT directed to the prostate and seminal vesicle. Median PSA was 8.3 ng/ml; 20 patients (35.7%) vs. 28 (50%) vs. 8 (22.3%) had a PCa Grade Group 1 vs. 2 vs. 3, respectively. All patients underwent hydrogel injection of Space OAR and intraprostatic fiducials before HRT. The prescription dose was 60 Gy in 20 fractions 5 days/week over 4 weeks. During the follow up, PSA, genitourinary (GU) and gastrointestinal (GI) toxicities were evaluated. The sexual function was evaluated by International Index of Erectile Function - 5 (IIEF-5) before, 6 and 18 months from HRT; 32/56 (57.1%) men referred a normal sexual activity before HRT (median IIEF-5 score: 22). Results: Median PSA level at median follow up of 18 months was 0.92 ng/ml and none used adjuvant therapy. One man (1.8%) referred a tardive grade 1 GU complication. At a median follow up of 6 and 18 months, 20/32 (62.5%) kept pretreatment sexual potency (median IIEF-5 score: 21). The 12/32 men who worsened the sexual function following HRT had a median age higher than patients without ED (78 vs. 67 years). Conclusions: The use of hydrogel injection and intraprostatic fiducials followed by HRT allowed to kept pretreatment sexual potency in 62.5% of the cases.

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How to Cite

Pepe, P., Tamburo, M., Panella, P., Pepe, L., Marletta, G., Pennisi, M., & Marletta, F. (2022). Erectile dysfunction following hydrogel injection and hypofractionated radiotherapy for prostate cancer: Our experience in 56 cases. Archivio Italiano Di Urologia E Andrologia, 94(2), 166–168. https://doi.org/10.4081/aiua.2022.2.166

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