The effects of a structured-exercise training program on erectile function, cardiovascular and respiratory parameters in men following prostate cancer treatment: Preliminary results from a randomised, controlled clinical trial in prostate cancer survivorship

Abstract

ABSTRACT Introduction Prostate cancer (PC) treatments can cause significant cardiovascular and sexual dysfunctions. There is limited data on the effects of structured exercise interventions specifically on the improvements of erectile function (EF) in the context of cardiovascular health and PC survivorship. It is postulated that structured physical exercise programs can result in positive changes in biomarkers of cardiovascular health through cardiovascular remodelling and in turns, will improve penile haemodynamic and EF recovery in PC men with erectile dysfunction (ED). Objective To explore the efficacy of structured-exercise training on EF, cardiorespiratory fitness (V̇O2peak), exercise capacity (peak power output; PPO) and vascular health (pulse wave velocity; PWV) in men with ED in the context of PC survivorship. Methods Following ethics approval, men who underwent radical prostatectomy and reported mild-to-moderate ED (defined as International Index of Erectile Function (IIEF-5) score of 8 to 21) were recruited and randomised to complete a thrice-weekly 12-week of structured aerobic and resistance high-intensity interval training (HIIT) intervention, or usual care. Changes in EF (based on IIEF-5 scores), V̇O2peak, PPO and PWV were assessed at baseline and 12 weeks follow-up. Results Of the 33 patients referred to the study, seven were ineligible due to severe (n=5) or normal (n=2) erectile function, with 12 agreeing to participate and blindly randomise into structured HIIT and usual care groups. Attendance to the 144 scheduled exercise sessions was 100%, with no study-related adverse events. At baseline, 75% of participants had a low V̇O2peak compared to normative data. After 12 weeks, EF (mean improvement in IIEF-5 by 5 points), V̇O2peak (INT=+3.7 mL/kg/min, CON=+0.4 mL/kg/min), absolute PPO (INT=+35 W, CON=+3 W) and PWV (INT=-3.16 m/s, CON=-0.95 m/s) were greater in the intervention group compared with the usual care group. Conclusions A 12-week structured HIIT exercise program is feasible, safe and has been shown to improve EF, cardiorespiratory fitness, exercise capacity and vascular health in men with PC. Disclosure Work supported by industry: no.