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New Onset of Erectile Dysfunction in a Cohort of Patients Enrolled in Active Surveillance for Low Risk Prostate Cancer: A Preliminary Study to Evaluate Incidence and Prognostic Factors

Luigi Quaresima, Massimo Polito, Camilla Capretti, Matteo Cevenini, Marco Tiroli and Andrea Benedetto Galosi

Objective: Active Surveillance (AS) is a viable alternative to surgery or radiotherapy dedicated to selected patients suffering from low-risk prostate cancer. Aim of the study was to evaluate the onset of Erectile Dysfunction (ED) in patients underwent to AS option and identify potential factors associated to the onset of ED.

Methods: From January 2011 to May 2014 were prospectively assessed patients included in AS; we evaluated baseline comorbidity including Diabetes, Hypertension, Body Mass Index (BMI), International Prostate Symptoms Score (IPSS) and International Index of Erectile Function-5 (IIEF-5) score. Were excluded from the assessment patients with baseline ED, defined as an IIEF-5 score < 22 and patient with follow-up less than 24 months.

Results: Among the 28 patients underwent to AS aged between 48 and 67 years who meet the selection criteria, 16 (57%) developed new onset of ED with different degrees. At multivariate analysis, no comorbidity were statistically associated to ED even thought a correlation with the onset of E.D. and BMI, Diabetes, Hypertension and age were founded.

Conclusions: AS is associated to a high occurrence of ED; among the comorbidities, BMI, Diabetes and Hypertension showed a correlation to a new onset of ED; additional studies are needed to confirm this hypothesis.