Katz Anne
University of Manitoba, Manitoba Prostate Centre, CancerCare Manibota, Winnipeg.
Can Fam Physician. 2005 Jul;51(7):977-82.
To describe the sexual consequences of prostate cancer and its treatments (prostatectomy, external beam radiation, brachytherapy, androgen deprivation therapy) and to suggest treatments for sexual side effects of these therapies.
Most studies of the sexual consequences of prostate cancer treatments and studies of therapy for these side effects provide level II evidence.
Diagnosis of prostate cancer in itself can cause sexual dysfunction. All forms of treatment for this cancer cause serious sexual problems for men. Treatments for the erectile dysfunction that results have varying success rates. Prostatectomy has been shown to cause erectile dysfunction in 30% to 98% of men, depending on whether both, one, or neither nerve bundles was spared. Radiation therapy results in erectile dysfunction in more than 70% of those treated; brachytherapy produces the least amount of sexual deficit. Hormone ablation therapy has serious consequences: more than 80% of men report loss of erections at 1 year after therapy in addition to profound loss of libido.
Family physicians are ideally placed to provide anticipatory guidance to men with prostate cancer on the sexual consequences of both the cancer and its treatments. Family physicians can also assist men and their partners in managing these sexual side effects.
描述前列腺癌及其治疗方法（前列腺切除术、外照射放疗、近距离放射疗法、雄激素剥夺疗法）对性功能的影响，并针对这些疗法的性副作用提出治疗建议。
大多数关于前列腺癌治疗对性功能影响的研究以及针对这些副作用的治疗研究提供的是二级证据。
前列腺癌的诊断本身可导致性功能障碍。这种癌症的所有治疗方式都会给男性带来严重的性问题。针对由此导致的勃起功能障碍的治疗成功率各不相同。前列腺切除术已被证明会导致30%至98%的男性出现勃起功能障碍，这取决于双侧、单侧或双侧神经束均未被保留。放射治疗会导致超过70%接受治疗的患者出现勃起功能障碍；近距离放射疗法导致的性功能缺陷最少。激素消融疗法有严重后果：超过80%的男性在治疗1年后报告勃起功能丧失，此外性欲也大幅下降。
家庭医生最适合为前列腺癌患者提供关于癌症及其治疗对性功能影响的预期指导。家庭医生还可以帮助男性及其伴侣应对这些性副作用。
