Treatment choice and sexual health outcomes in gay and bisexual men with prostate cancer.

BACKGROUND

The differential impacts of radical prostatectomy (RP) and external beam radiotherapy (EBRT) on sexual health in gay and bisexual men (GBM) with prostate cancer remain understudied, limiting recommendations incorporating preferred sexual behavior.

METHODS

Secondary analysis of Restore-2 compared outcomes in GBM after RP (n = 127) or EBRT (n = 27).

RESULTS

Compared to RP, EBRT was associated with lower rates of climacturia (11% vs. 59%, p < 0.001), condom-related erectile dysfunction (27% vs. 51%, p = 0.047), and decreased penile length/girth (49% vs. 69%, p = 0.07), but higher rates of anodyspareunia (33% vs. 14%, p = 0.06).

CONCLUSIONS

Exploratory findings suggest EBRT for insertive intercourse, RP for receptive intercourse.