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Pathophysiology of Erectile Dysfunction Following Radiation Therapy

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Book cover Sexual Function in the Prostate Cancer Patient

Part of the book series: Current Clinical Urology ((CCU))

Abstract

The development of erectile dysfunction (ED) after definitive prostate radiotherapy is multi-factorial in nature, and the major pathophysiologic injuries differ from those that affect patients after radical prostatectomy (RP). There is now compelling evidence that endothelial cell damage in nearby erectile tissue as a direct result of radiotherapy contributes significantly to the relatively delayed onset of post-treatment ED. Conversely, the injury to the neurovascular bundles that is central to the onset of ED after RP does not appear to be a major causative force in the setting of radiotherapy. Whether damage to the penile bulb contributes to the onset of radiation-associated impotence (RAI) is highly controversial and remains unclear. This review will examine the various functional and observational studies that have helped to highlight the injuries relevant to the development of RAI.

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Authors and Affiliations

  1. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Victoria J. Croog

  2. Professor of Radiation Oncology, Chief, Brachytherapy Service, Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Michael J. Zelefsky

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  1. Victoria J. Croog
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  2. Michael J. Zelefsky
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    © 2009 Humana Press, a part of Springer Science+Business Media, LLC

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    Croog, V.J., Zelefsky, M.J. (2009). Pathophysiology of Erectile Dysfunction Following Radiation Therapy. In: Mulhall, J. (eds) Sexual Function in the Prostate Cancer Patient. Current Clinical Urology. Humana Press. https://doi.org/10.1007/978-1-60327-555-2_4

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    • DOI: https://doi.org/10.1007/978-1-60327-555-2_4

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