Abstract
BACKGROUND AND PURPOSE: Radical prostatectomy can cause erectile dysfunction; however, subsequent treatment with, e.g., phosphodiesterase-5 inhibitors may improve sexual function in the patients. We aim to examine prescriptions for erectile dysfunction after radical prostatectomy and to identify factors that may affect the prescription rate. PATIENTS AND METHODS: A study based on men included in the Danish Prostate Registry (DanProst) in 1995-2021, and information on prescriptions for erectile dysfunction (ATC: G04BE) from the Danish Prescription Registry. We calculated the proportion of prescriptions per month from 1 year before to 2 years after the initial biopsy and odds ratios (ORs) with 95% confidence intervals (CIs) for the risk of having a prescription. RESULTS: We included 9,286 men with radical prostatectomy, 4,221 men managed on active surveillance, and 47,572 men with nonmalignant biopsies for comparison. The proportion of prescriptions increased significantly after biopsy among men with radical prostatectomy compared to men with nonmalignant biopsies and active surveillance. Patients with prior prescriptions for erectile dysfunction had an OR of 3.49 (95% CI, 2.98-4.08) of new prescriptions 6 months after the initial biopsy. Compared to patients treated with bilateral nerve-sparing surgery, patients with unilateral nerve-sparing surgery had an OR of 1.23 (95% CI, 1.06-1.43), whereas patients without nerve-sparing surgery had an OR of 0.40 (95% CI, 0.34-0.46). INTERPRETATION: The observed patterns of prescriptions demonstrate a high demand for the treatment of erectile dysfunction following radical prostatectomy. The group of prostate cancer survivors is large, and, thus, a strong clinical focus on managing erectile dysfunction is needed.