Prevalence and patterns of sexual dysfunctions among male cancer survivors: real-world evidence from a tertiary andrology centre.

Male cancer survivors may develop sexual dysfunction (SD) even many years after recovery from cancer. We aimed to evaluate the prevalence of and the clinical characteristics of cancer survivors among men seeking medical help for SD (any) in the real-life setting of an andrological tertiary-referral centre. Complete data from 2712 men consecutively assessed for new-onset SD between 2005 and 2022 were analysed. All patients were assessed with a comprehensive sexual and medical history, including history of any non-metastatic cancer (i.e., urological cancers, non-urological solid cancers, haematological malignancies). All patients were invited to complete the International Index of Erectile Function (IIEF). The IIEF-Erectile function (IIEF-EF) domain was categorized according to Cappelleri's criteria. Of all, 239 (8.8%) patients primarily assessed for SD reported a history of non-metastatic cancers. Among cancer survivors, the most frequent complaint was ED (76.2%), followed by Peyronie's disease (PD) (13.8%), low sexual desire/interest (LSD/I) (13.4%), premature ejaculation (PE) (6.7%), and delayed ejaculation (DE) (2.1%), respectively. Of all, prostate cancer (PCa) and colorectal cancer (CRC) survivors accounted for 36.0% and 10.5% of all cancer survivors, respectively. Men with a history of PCa and/or CRC more frequently complained of ED [104(93.7) vs. 78(60.9) men; p = 0.002] and had lower median (IQR) IIEF-EF scores [7(3-10.5) vs. 11(7-21); (p < 0.001)], compared to patients with a history of other malignancies, whom conversely reported higher rates of PE [4(3.6%) vs. 12(9.4%) men; p = 0.04] and PD [10(9.0%) vs. 23(18.0%) men; p = 0.009]. Almost one out of ten men seeking first medical help for SD in a tertiary-referral andrology centre are cancer survivors. Following the improvement of survivorship rates in male patients, an andrological assessment should always be included over the follow-up of cancer survivors.