Radiation-associated impotence. A clinical study of its mechanism
I. Goldstein, M. I. Feldman, P. J. Deckers, R. K. Babayan and R. J. Krane
External beam pelvic irradiation in men is frequently complicated by
erectile dysfunction. We tested the erectile function in 23 patients (mean
age, 65 years) who received radiation therapy for prostate cancer. Fifteen
patients experienced changes in erectile potency following radiotherapy.
Neurological, endocrine, and vascular testing revealed abnormalities in 0,
5, and 15 of these patients, respectively. In two, arteriography revealed
bilateral occlusive disease in the distal internal pudendal and penile
arteries overlying the pelvic radiation field. A significant difference
with cigarette smoking was found among the 15 patients whose erectile
capacity decreased and the four patients whose capacity remained unchanged.
Vasculogenic impotence is the most consistent organic erectile abnormality
in RAI.
