Prevalence of erectile dysfunction and its association with age in patients with metastatic renal cell carcinoma: results from a prospective multicenter study.

Abstract

Background: This study aimed to evaluate the prevalence of erectile dysfunction (ED) and assess its associations in a large cohort of patients with metastatic renal cell carcinoma (mRCC) prior to initiating and during therapy.

Methods: In this prospective multicenter study, male patients with clear-cell mRCC were assessed. Erectile function was evaluated using the 5-item International Index of Erectile Function (IIEF-5), and general health status was assessed using the Functional Assessment of Cancer Therapy-Kidney Symptom Index (FKSI-19). Associations between clinical factors and IIEF-5 scores were analyzed using multiple regression models.

Results: Among 357 patients (median age 62.9 years), 69% reported negative changes in sexual life, and 77.8% had some degree of ED. 62% of patients reported no sexual activity. Although older age, poor or intermediate IMDC risk, and greater symptom severity were associated with lower IIEF-5 scores in univariate analyses, age was not an independent predictor of ED. Instead, ECOG performance status, hemoglobin levels, and FKSI-19 scores significantly predicted ED level.

Conclusions: ED is highly prevalent among patients with mRCC and appears to be more strongly associated with general health and disease burden rather than age. These findings highlight the importance of evaluating sexual health in oncology settings, irrespective of age.