Abstract
To investigate the prevalence of premature ejaculation (PE) and erectile dysfunction (ED) in a sample of patients with prostate cancer and to determine the utility of the previously suggested cutoffs of the Premature Ejaculation Diagnostic Tool (PEDT) for the diagnosis of PE and that of International Index of Erectile Function (IIEF-5) for ED. A total of 1,202 men with prostate cancer were invited from urology clinics at the universities of Iran, Tehran, Qazvin, Ahvaz, Guilan and Tabriz. Clinical characteristics were collected through medical records. PE and ED diagnoses were made by trained urologists. In addition to the clinical diagnoses, PE and ED were measured through self-report using the PEDT and the IIEF-5. Questionnaire cutoff scores were determined using receiver operating characteristic (ROC) curves and confirmed by predictive ability using logistic regression. The prevalence of PE was 63.7% and that of ED was 66.2%. Prevalences of PE decreased and that of ED increased with advanced TNM stages. According to ROC, the suggested cutoff for the PEDT to diagnose a PE was ≥ 11 (sensitivity=0.988, 1-specificity=0.084, and predictive ability=0.914) and ≤ 17 for the IIEF-5 (sensitivity=0.966, 1-specificity=0.031, and predictive ability=0.967). Prevalence of sexual problems was high in prostate cancer patients in Iran, therefore oncologists should take into account these potential problems when deciding on treatment modalities.
Highlights
Premature ejaculation (PE) and erectile dysfunction (ED) are the two most common sexual problems in male population with reported prevalences of up to 38% (Spector and Carey, 2009) for premature ejaculation (PE) and up to 52% for ED (Rosen et al, 1999)
Prevalence of sexual problems was high in prostate cancer patients in Iran, oncologists should take into account these potential problems when deciding on treatment modalities
Prevalences tend to be higher in certain clinical populations, such as for example men suffering from short frenulum (Gallo et al, 2010), and those who had worse control over ejaculation (Giuliano et al, 2014; Gagnon and Polverejan,2008).This may be true for prostate cancer patients who have reported problems relating to erectile and ejaculatory function caused by certain treatments (Singer et al, 1991; Benson et al.,2012) and have shown to accept at least a 10% decrement in survival for a treatment that grants a better chance of preserving their erectile function (Incrocci et al, 2002); assessing the prevalence of PE and ED in prostate cancer patients is critical in the cancer epidemiology
Summary
Premature ejaculation (PE) and erectile dysfunction (ED) are the two most common sexual problems in male population with reported prevalences of up to 38% (Spector and Carey, 2009) for PE and up to 52% for ED (Rosen et al, 1999). The benefits of using such measures are obvious as they offer the possibility to gather a lot of data by the simple and quick administration of short questionnaires to evaluate the sexual function in large population samples Two such validated and very widely used questionnaires are the Premature Ejaculation Diagnostic Tool (PEDT) for the assessment of ejaculatiory function (Symonds et al, 2007) and the International Index of Erectile Function (IIEF-5) for the assessment of erectile function (Rosen et al, 1999) - both of which consist of 5 items only. To investigate the prevalence of premature ejaculation (PE) and erectile dysfunction (ED) in a sample of patients with prostate cancer and to determine the utility of the previously suggested cutoffs of the Premature Ejaculation Diagnostic Tool (PEDT) for the diagnosis of PE and that of International Index of Erectile Function (IIEF-5) for ED. Conclusions: Prevalence of sexual problems was high in prostate cancer patients in Iran, oncologists should take into account these potential problems when deciding on treatment modalities
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