Secondary analysis compares sexual health impacts of radical prostatectomy and external beam radiotherapy in gay and bisexual men, suggesting distinct benefits for each treatment method.
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.
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Dickstein et al. (2025) studied this question.
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