Table 6.
Use and Reported Effectiveness of Medications and Devices for Erectile Dysfunction 2 Years After Primary Prostate Cancer Treatment Among 694 Men Who Had Reported Functional Erections Suitable for Intercourse Pretreatment in the PROSTQA Cohorta
| Medication or Device | Patient-Reported Effectiveness, No. (%)b | |||||
|---|---|---|---|---|---|---|
| Have Not Tried It |
Ineffective (Tried It But It Was Not Helpful) |
Effective | ||||
| I Use It Always |
I Use It Sometimes |
It Helped, But I Am Not Using It Now |
||||
| PDE-5 inhibitors | ||||||
| Prostatectomy (n = 412) | 131 (32) | 111 (27) | 51 (12) | 86 (21) | 33 (8) | |
| External radiotherapy (n = 120) | 72 (60) | 10 (8) | 11 (9) | 22 (18) | 5 (4) | |
| Brachytherapy (n = 162) | 75 (46) | 13 (8) | 29 (18) | 34 (21) | 11 (7) | |
| Overall (of 416 trying) | 134 (32) | 91 (22) | 142 (34) | 49 (12) | ||
| Intraurethral alprostadil | ||||||
| Prostatectomy (n = 412) | 351 (85) | 31 (8) | 5 (1) | 13 (3) | 12 (3) | |
| External radiotherapy (n = 120) | 115 (96) | 1 (1) | 1 (1) | 2 (2) | 0 | |
| Brachytherapy (n = 162) | 159 (98) | 1 (1) | 0 | 0 | 1 (1) | |
| Overall (of 67 trying) | 33 (49) | 6 (0) | 15 (22) | 13 (19) | ||
| Penile injections | ||||||
| Prostatectomy (n = 412) | 352 (86) | 16 (4) | 12 (3) | 10 (2) | 21 (5) | |
| External radiotherapy (n = 120) | 116 (97) | 1 (1) | 0 | 2 (2) | 1 (1) | |
| Brachytherapy (n = 162) | 159 (98) | 0 | 0 | 0 | 3 (2) | |
| Overall (of 66 trying) | 17 (26) | 12 (18) | 12 (18) | 25 (38) | ||
| Vacuum erection device | ||||||
| Prostatectomy (n = 412) | 332 (81) | 27 (7) | 12 (3) | 21 (5) | 20 (5) | |
| External radiotherapy (n = 120) | 115 (97) | 0 | 1 (1) | 1 (1) | 1 (1) | |
| Brachytherapy (n = 162) | 161 (99) | 0 | 0 | 0 | 1 (1) | |
| Overall (of 84 trying) | 27 (32) | 13 (15) | 22 (26) | 22 (26) | ||
Abbreviations: PDE-5, phosphodiesterase 5; PROSTQA, Prostate Cancer Outcomes and Satisfaction With Treatment Quality Assessment.
Use of medications or devices was measured by a previously described standard question set for use with the Expanded Prostate Cancer Index Composite.18 From among 694 men across all 3 treatment groups who reported erections suitable for intercourse at baseline, 328 reported erections suitable for intercourse at 2 years after treatment; 199 (61% [95% CI, 55%–66%]) of these 328 reported use of aids or medications for erectile dysfunction. Of the remaining 352 who reported erections not suitable for intercourse at 2 years, 218 (62% [95% CI, 57%–67%]) reported use of aids or medications for erectile dysfunction.
Values may not sum to total number of patients because of occasional missing values. Medications and devices considered effective if response was “I use it always,” “I use it sometimes,” or “It helped, but I am not using it now”; denominator for response rates is limited to patients reporting having tried the medication/device.