Ejaculatory dysfunction (EjD) and erectile dysfunction after cancer treatment are clinically important complications, but their exact prevalence by various kinds of cancer site and type of treatment is unknown. The aim of this systematic review and meta-analysis was to examine the available evidence and provide pooled estimates for prevalence of EjD and erectile dysfunction in relation to all cancer sites and identify characteristics associated with EjD in cancer patients.
We performed a systematic review and meta-analysis of cross-sectional and case-control studies. We searched four electronic databases (Medline, CINAHL, PsychInfo and Embase) until 22nd July 2020. All retrospective or prospective studies reporting the prevalence of EjD in male patients with cancer were included in this review. A random effects meta-analysis was conducted calculating prevalence proportions with 95% confidence intervals (CIs). Prevalence proportions were calculated for the incidences of EjD by cancer site and type of treatment.
A total of 64 studies (a total of 10,057 participants) were included for analysis. The most common cancer sites were bladder, colon, testis and rectum. The prevalence rates of EjD after surgical intervention ranged from 14.5% (95% CI 2.2-56.3%) in colon cancer to 53.0% (23.3-80.7%) in bladder cancer. The prevalence rates of erectile dysfunction ranged from 6.8% (95% CI 0.8-39.1%) in bladder cancer to 68.7% (95% CI 55.2-79.6%) in cancer of the rectum.
In a large study-level meta-analysis, we looked at a high prevalence of EjD and erectile dysfunction at various cancer sites and across different treatment types. Prospective studies of EjD and erectile dysfunction after various kinds of cancer treatments are warranted.
The Journal of urology. 2021 Jul 21 [Epub ahead of print]
Damiano Pizzol, Mike Trott, Igor Grabovac, Lin Yang, Yvonne Barnett, Christopher Parris, Daragh T McDermott, Nicola Veronese, Andreas Kronbichler, Ramy Abou Ghayda, Pinar Soysal, Louis Jacob, Mark A Tully, Ai Koyanagi, Christopher Tejun Law, Coskun Kaya, Nannan Thirumavalavan, Aram Loeb, Andrea Garolla, Seoyeon Park, Jae Il Shin, Petre Cristian Ilie, Lee Smith
Italian Agency for Development Cooperation, Khartoum, Sudan., The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK., Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria., Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada., Faculty of science and Engineering, Anglia Ruskin University, Cambridge, UK., Biomedical Research Group, School of Life Sciences, Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, UK., Faculty of Science and Engineering, Nottingham Trent University, Nottingham, UK., Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy., Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria., Urology Institute, University Hospitals System, Case Western Reserve University School of Medicine, Cleveland, Ohio., Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey., Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France., Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, Northern Ireland., Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain., Barts and The London School of Medicine and Dentistry, Queens Mary University of London, London, UK., Eskisehir City Hospital, Department of Urology, Eskisehir, Turkey., Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy., Yonsei University College of Medicine, Seoul, Republic of Korea., Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea., Research and Innovation Department, The Queen Elizabeth Hospital Foundation Trust, King's Lynn, UK.