title: Prevalence of Baseline Erectile Dysfunction (ED) in an Australian Cohort of Men with Localized Prostate Cancer.
abstract: BACKGROUND
  Erectile dysfunction (ED) is a common complication following prostate cancer treatment. Post-treatment erectile function (EF) preservation is strongly dependent on the baseline EF prior to treatment.
  
  
  OBJECTIVE
  To assess the baseline EF among patients with localized prostate cancer, and the factors associated with baseline EF.
  
  
  METHODS
  All men with clinically localized prostate cancer had their baseline EF assessed prior to brachytherapy at our institution. Six hundred ninety-nine men who completed the International Index of Erectile Function five-item questionnaires pre-treatment between 2001 and 2013 were included in the study. Data on patient factors (medical comorbidities and smoking history) and prostate cancer clinicopathological characteristics were recorded. Ordinal logistic regressions were used to estimate the effects of each variable on the severity of ED.
  
  
  METHODS
  Baseline EF among men with localized prostate cancer, and factors associated with ED.
  
  
  RESULTS
  Prior to permanent seed brachytherapy, 335 (48%) patients reported no ED, 129 (17%) mild ED, 42 (6%) mild-moderate ED, 37 (5%) moderate ED, and 165 (24%) severe ED. In multivariate analyses, age, diabetes, and hypertension remained to be independently associated with ED, with diabetes most strongly associated with worse ED (odds ratio = 2.6; 95% confidence interval = 1.3-5.3).
  
  
  CONCLUSIONS
  ED is common among patients with localized prostate cancer prior to any curative treatment. Assessment of baseline ED is important prior to curative treatment of prostate cancer in order to offer appropriate advise on likelihood of EF preservation post-treatment and avoid patient dissatisfaction with treatment outcomes due to unrealistic expectations.
authors.affiliation: William Buckland Radiation Oncology Service, Alfred Health, Melbourne, Vic., Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic., Australia.
authors.forename: Wee Loon
authors.initials: WL
authors.lastname: Ong
authors.affiliation: William Buckland Radiation Oncology Service, Alfred Health, Melbourne, Vic., Australia.
authors.forename: Hamish
authors.initials: H
authors.lastname: McLachlan
authors.affiliation: William Buckland Radiation Oncology Service, Alfred Health, Melbourne, Vic., Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic., Australia.
authors.forename: Jeremy L
authors.initials: JL
authors.lastname: Millar
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D001918:Brachytherapy / Q000009:adverse effects / Q000706:statistics & numerical data; D015897:Comorbidity; D048909:Diabetes Complications / Q000453:epidemiology; D007172:Erectile Dysfunction / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000503:physiopathology / Q000532:radiotherapy; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Epidemiology; Erectile Dysfunction; IIEF-5; Prostate Cancer