Pretreatment evaluation of sexual function in patients with adenocarcinoma of the prostate

Forty-three patients with adenocarcinoma of the prostate and available partners were interviewed to assess qualitatively and quantitatively their levels of sexual functioning prior to radiotherapy. The mean age was 67.7 years (58-80 years). The Derogatis Interview for Sexual Functioning (DISF) was the evaluation used. The Derogatis Interview for Sexual Functioning measures five domains of sexual functioning: sexual fantasy, arousal, experience, orgasm, and drive. Twenty-seven of the 43 (62.7%) patients evaluated were considered impotent. Fifteen of the 27 patients scored low in all five domains of sexual functioning even though they could achieve erection but they were unable to maintain erection throughout the phases of the sexual response cycle. Twelve of the 27 patients had scored 0 on sexual arousal and orgasm, thus had no ability for erection. Sixteen of the 43 (37.2%) patients were considered potent. This group of patients had achieved erection throughout the phases of sexual cycle and scored adequately in all five domains of sexual functioning. Patients with DISF score less than 20 were impotent. Those with a Derogatis Interview for Sexual Functioning score of greater than 45 were potent. Only 6 of 19 patients with scores between 20 and 45 were potent. The Derogatis Interview for Sexual Functioning score was highly prognostic for impotence, (p = .002) was easy to use and could be used for follow-up of the effect of therapy on sexual function in patients with adenocarcinoma of the prostate. Patients who present for radiation therapy are older, 50% are on cardiac or antihypertensive medication, and the majority (62.7%) are already impotent prior to therapy.