Ejaculation profiles in men after irreversible electroporation for prostate cancer

Abstract

ABSTRACT Introduction Irreversible Electroporation (IRE) is an evolving strategy for the management of localized prostate cancer. Little data exists on sexual function, in particular ejaculation, in such patients. Objective We aimed to report the ejaculatory function in patients undergoing IRE. Methods Patients undergoing IRE with ≥1-year follow-up were evaluated. These patients were selected for focal therapy and consented to participate in a prospective registry. Eligibility criteria: Gleason score 3+4, PSA <20, no evidence of extracapsular extension, seminal vesicle invasion or lymph node involvement on standard imaging. The Gleason score 3+4 prostate cancer was allowed up to a maximum of two adjacent sextants within the prostate gland. Concomitant Gleason score 6 was untreated and monitored on active surveillance. They completed the Male Sexual Health Questionnaire ejaculation domain short form (MSHQ-EFD-SF) at 6 weeks, 3 months, 6 months, and 12 months post-IRE. This questionnaire has 4 questions: 3 questions sum scores (range 1-15), where lower scores indicate worse ejaculatory function, and the MSHQ-Bother question score (ranges 0-5), with higher scores indicating higher bother associated with ejaculatory difficulties. Comorbidities, demographics, and pathology parameters were recorded. Results 20 men have been evaluated to date with a mean age of 64.3 ± 4.8 years. Baseline testosterone and PSA were 536.3 ± 267.6 ng/dL and 6.2 ± 2.7 ng/mL. Mean prostate volume was 45.6 ± 11.9 cc. Median baseline score of MSHQ-EJD-SF was 13.5 (IQR 10, 14), and post-procedure median scores were 11 at 6 weeks; 12.5 at 3 months; 12 at 6 months; and 11.5 at 12 months (p-value =0.036). Scores for ejaculation strength and seminal volume ejaculated decreased significantly, and bother scores increased significantly between baseline and 1-year post-IRE. The ability to ejaculate during sexual activity did not change over time. Conclusions In our cohort of patients with prostate cancer who underwent IRE there was a significant difference in ejaculatory profiles between baseline and 1-year post-IRE. Disclosure Work supported by industry: no.