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Ejaculatory function after radiotherapy for prostate cancer: a systematic review and meta-analysis

Prostate Cancer and Prostatic Diseases (2024)Cite this article

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Abstract

Background

Scant data exists on the impacts of prostate radiation on ejaculatory function. We performed a systematic review and meta-analysis to assess ejaculatory outcomes in men after prostate radiation.

Methods

We queried PubMed, Embase, and Web of Science to identify 17 articles assessing ejaculatory function post-radiation. The primary outcome was anejaculation rate and secondary outcomes included ejaculatory volume (EV), ejaculatory discomfort, and mean decline in ejaculatory function scores (EFS). We assessed study quality with the Newcastle-Ottawa scale. We calculated pooled proportions using inverse variance and random effects models.

Results

We identified 17 observational studies with 2156 patients reporting ejaculatory profiles post-radiation. Seven studies utilized external beam radiation therapy, 7 brachytherapy, 1 stereotactic RT and 2 utilized either external or brachytherapy. Ten studies reported an anejaculation rate. Pooled proportion of patients having anejaculation, decreased EV and EjD were 18% (95% CI, 11–36%), 85% (95% CI, 81–89%) and 24% (95% CI, 16–35%), respectively. Five studies reported decline in EFS post-radiation.

Conclusions

Patients receiving radiation treatment may experience significant changes in their ejaculation, such as the absence of ejaculation, reduced EV, and EjD. It is important to counsel them about these potential side effects.

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Authors and Affiliations

  1. Department of Urology, University of California San Francisco, San Francisco, CA, USA

    Umar Ghaffar, Behzad Abbasi, Kevin D. Li, Nizar Hakam, Adrian Fernandez, Robert Pearce, Hiren V. Patel, Marvin N. Carlisle & Benjamin N. Breyer

  2. Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA

    Kevin D. Li & Benjamin N. Breyer

  3. Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA

    Nikit Venishetty

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Contributions

Conceptualization, Methodology, Writing - Original Draft Preparation: UG, AF, RP, HP, MC. Data Curation: UG, BA, KL, NV, NH. Formal Analysis, Methodology: UG, BA. Writing - Review & Editing, Supervision: UG, BA, KL, NV, BB, AF. Project Supervision: AF, HP, BB.

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Correspondence to Benjamin N. Breyer.

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Ghaffar, U., Abbasi, B., Li, K.D. et al. Ejaculatory function after radiotherapy for prostate cancer: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis (2024). https://doi.org/10.1038/s41391-024-00882-4

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