Taking advantage of the extended registration of health data performed in Denmark, we examined prescription proportions for erectile dysfunction after radical prostatectomy and identified factors affecting the proportion. As expected, the proportion of prescriptions increased significantly in men treated with radical prostatectomy compared to men with non-malignant biopsies and prostate cancer patients managed on active surveillance. Lower age, nerve-sparing surgery, and previous prescriptions of drugs for erectile dysfunction were associated with a higher proportion of redeemed prescriptions for erectile dysfunction.
Although the findings indicate a high rate of erectile problems following radical prostatectomy, the findings cannot be interpreted as either incidence or prevalence of erectile dysfunction. Since phosphodiesterase-5 inhibitors are also used for prophylaxis and rehabilitation of erectile dysfunction, a redemption of prescription of drugs for erectile function is not equivalent to an existing condition.9 Conversely, men without a prescription may have erectile dysfunction but are either unlikely to have any effect of the treatment or have no desire to maintain erectile function.
However, the patterns of prescriptions shown in this study clearly demonstrate a high demand for treatment of erectile dysfunction following radical prostatectomy. We, therefore, encourage counseling of the patients regarding the choice of treatment, and men with a large desire for maintenance of erectile function may be better suited to receive either active surveillance or radiotherapy if possible.
Written by: Signe Benzon Larsen, PhD, MSc, Department of Urology, Urological Research Unit, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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