Ghaffar Umar, Abbasi Behzad, Li Kevin D, Venishetty Nikit, Hakam Nizar, Fernandez Adrian, Pearce Robert, Patel Hiren V, Carlisle Marvin N, Breyer Benjamin N
Department of Urology, University of California San Francisco, San Francisco, CA, USA.
Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
Prostate Cancer Prostatic Dis. 2024 Sep 14. doi: 10.1038/s41391-024-00882-4.
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.
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.
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.
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.
关于前列腺放疗对射精功能影响的数据很少。我们进行了一项系统评价和荟萃分析，以评估前列腺放疗后男性的射精结果。
我们检索了PubMed、Embase和Web of Science，以确定17篇评估放疗后射精功能的文章。主要结局是无射精率，次要结局包括射精量（EV）、射精不适以及射精功能评分（EFS）的平均下降情况。我们使用纽卡斯尔-渥太华量表评估研究质量。我们使用逆方差和随机效应模型计算合并比例。
我们确定了17项观察性研究，共2156例患者报告了放疗后的射精情况。7项研究使用了外照射放疗，7项使用近距离放疗，1项使用立体定向放疗，2项使用外照射或近距离放疗。10项研究报告了无射精率。无射精、射精量减少和射精不适患者的合并比例分别为18%（95%CI，11-36%）、85%（95%CI，81-89%）和24%（95%CI，16-35%）。5项研究报告了放疗后射精功能评分的下降情况。
接受放疗的患者射精功能可能会发生显著变化，如无射精、射精量减少和射精不适。告知他们这些潜在的副作用很重要。
