The Effect of Radiation on Erectile Function

Abstract

Pelvic radiation and brachytherapy have been used for decades to manage prostate cancer. Although the oncologic outcomes have been closely monitored, much less is known about the sexual dysfunction that occurs secondary to these treatment modalities. Erectile dysfunction is by far the most common sexual sequela of pelvic radiation. This chapter endeavors to discuss the pathophysiology of erectile dysfunction after radiation treatment, as well as current limitations in the literature which confound our ability to counsel patients regarding the risk of sexual dysfunction. Outcomes of external beam radiation and brachytherapy are also addressed individually, and aspects unique to various treatment modalities including the use of androgen deprivation therapy are highlighted.