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A Clinical Study of Its Mechanism

Irwin Goldstein, MD; Merrill I. Feldman, MD; Peter J. Deckers, MD; Richard K. Babayan, MD; Robert J. Krane, MD

JAMA. 1984;251(7):903-910.

Abstract
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.

(JAMA 1984;251:903-910)

Author Affiliations
From the Departments of Urology (Drs Goldstein, Babayan, and Krane), Radiation Medicine (Dr Feldman), and Surgery (Dr Deckers), Boston University School of Medicine.

Footnotes
Reprint requests to University Hospital, 75 E Newton St, Boston, MA 02118 (Dr Goldstein).

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