长期前列腺癌治疗幸存者中用于勃起功能障碍的药物或器械的使用：性动机和/或冷漠的潜在影响。

Use of medications or devices for erectile dysfunction among long-term prostate cancer treatment survivors: potential influence of sexual motivation and/or indifference.

作者信息

Miller David C, Wei John T, Dunn Rodney L, Montie James E, Pimentel Hector, Sandler Howard M, McLaughlin P William, Sanda Martin G

机构信息

Michigan Urology Center, University of Michigan Medical Center, Ann Arbor, Michigan, USA.

出版信息

Urology. 2006 Jul;68(1):166-71. doi: 10.1016/j.urology.2006.01.077.

DOI:10.1016/j.urology.2006.01.077

PMID:16844457

Abstract

OBJECTIVES

To evaluate the potential association between sexual motivation and patterns of erectile dysfunction (ED) therapy among a large cohort of localized prostate cancer treatment survivors.

METHODS

The use of medications and devices to improve erections and sexual health-related quality of life (HRQOL) were evaluated using a mailed Expanded Prostate Cancer Index Composite survey administered to 896 men 4 to 8 years after brachytherapy, three-dimensional conformal external beam radiotherapy (3D-CRT), or radical prostatectomy and 112 control men. The responding participants (73% of those surveyed) were classified by prostate cancer treatment, sexual motivation, and ED therapy use. Bivariate and multivariate analyses were used to identify the factors associated with ED therapy use and sexual HRQOL outcome.

RESULTS

The quality of erections unassisted by medications or devices was not different among the treatment groups. Prostate cancer survivors used medications or devices for ED more commonly than did the control men (30% versus 13%; P <0.01). One half of the prostate cancer survivors with ED reported indifference regarding their ED (small to no sexual bother despite absent or poor unassisted erections). Conversely, among men who were bothered by poor erections, 48% of the brachytherapy, 61% of the 3D-CRT, and 23% of radical prostatectomy subjects had never tried commonly available medications or devices to improve their erections (P <0.01). The current use of at least one erection aid was an independent determinant of more favorable sexual HRQOL (P <0.01).

CONCLUSIONS

Many men who are bothered by posttreatment ED reported never having tried medications or devices to improve their erections. The lack of ED therapy was more prevalent among patients with erectile concerns after brachytherapy or 3D-CRT than after radical prostatectomy, suggesting possible opportunities for improving sexual HRQOL among long-term survivors.

摘要

目的

评估一大群局限性前列腺癌治疗幸存者中性动机与勃起功能障碍（ED）治疗模式之间的潜在关联。

方法

通过对896名接受近距离放射治疗、三维适形外照射放疗（3D - CRT）或根治性前列腺切除术后4至8年的男性以及112名对照男性进行邮寄的扩展前列腺癌指数综合调查，评估用于改善勃起功能和性健康相关生活质量（HRQOL）的药物和器械的使用情况。根据前列腺癌治疗、性动机和ED治疗使用情况对回复的参与者（占调查对象的73%）进行分类。采用双变量和多变量分析来确定与ED治疗使用和性HRQOL结果相关的因素。

结果

各治疗组中未借助药物或器械的勃起质量无差异。前列腺癌幸存者比对照男性更常使用药物或器械治疗ED（30%对13%；P<0.01）。一半有ED的前列腺癌幸存者表示对其ED漠不关心（尽管未借助或勃起不佳，但性困扰小或无）。相反，在因勃起不佳而困扰的男性中，48%的近距离放射治疗患者、61%的3D - CRT患者和23%的根治性前列腺切除术患者从未尝试过常用药物或器械来改善勃起（P<0.01）。当前至少使用一种勃起辅助器具是性HRQOL更有利的独立决定因素（P<0.01）。