Raising the subject – let’s talk about erectile dysfunction

Introduction: Erectile dysfunction (ED) is a significant side-effect from radical treatment modalities for patients diagnosed with prostate cancer. ED can impact patient’s self-esteem and masculinity [1], resultantly these patients are at a high risk of developing depressive symptoms [2]. ED is not routinely discussed in the radiographer-led review clinics in the author’s clinical department. The team wished to establish if the introduction of the International Index of Erectile Function-5 (IIEF-5) questionnaire in the radiographer-led review clinics would aid patients to raise ED concerns and increase referral rates. Method and Materials: A retrospective baseline audit of 96 patients receiving radical radiotherapy for prostate cancer over a 3-month period was completed to assess if ED had been discussed and the number of patients referred to specialist ED clinics. A prospective service evaluation of all patients receiving radical radiotherapy for prostate cancer over a 3 month period was completed. Patients were asked to return the completed IIEF-5 questionnaire in their review. Responses were discussed, and referral to specialist clinics completed if required. Results: The retrospective baseline audit identified ED was only discussed in 7 reviews of those 96, with 6 patients referred to a specialist clinic. 122 patients have been provided with IIEF-5 in the prospective service evaluation. Patient response to the questionnaires has been mixed, 23 patients have declined to complete the IIEF-5 questionnaire outright. Only 34 patients have returned their completed IIEF-5 questionnaire. From these patients, 29 patients felt ED was not a concern to them and they did not want referral. 5 patients have requested referral to a specialist clinic. Conclusions and Discussion: The evidence-base has identified the importance of healthcare professionals raising the subject of ED with patients [3]. The results have not presently identified an increase in the number of referrals to specialist clinics but the numbers are comparable. IIEF-5 is increasing radiographer and patient awareness leading to the issue being discussed. Further work with focus groups will be conducted to assess and evaluate the appropriateness of the IIEF-5 for these patients.