Does HIFU Cause Erectile Dysfunction?

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High-intensity focused ultrasound (HIFU) is a radiation-free therapy that technically has been approved for prostate tissue ablation. That means it can be used to treat prostate cancer, although the FDA approval (since 2015) is not specifically for that purpose. When HIFU is used to treat prostate cancer, the ultrasound waves are sent through the rectum walls, where they generate sufficient heat to destroy cancerous prostate cells. HIFU is designed to destroy prostate cancer cells while also preserving the integrity of the prostate gland, which minimizes the occurrence of side effects, but men may have questions about HIFU and erectile dysfunction. The procedure is not appropriate for cancer that has metastasized beyond the prostate.

HIFU has been available for treating benign prostatic hyperplasia, localized whole-gland prostate cancer, and recurrent prostate cancer for more than 15 years in Europe, Asia, and other countries, so most of the research on its effect on erectile function comes from those experiences.

How Are HIFU and Erectile Function Related?

The impact of HIFU on erectile function has not been well researched, although several studies have provided some results. A study published in the Journal of Sexual Medicine reported that 36 months after undergoing HIFU, 65.5 percent of men had regained erectile function. In another study, however, the erectile dysfunction rate was 77 percent over a mean of 41 months. A review of HIFU and erectile dysfunction found that the side effect occurs in the range of 20 to 49.8 percent of men who have the procedure. It is important to ask your doctor about risks and side effects of prostate cancer treatments before starting any treatment so you know what to expect.

References for HIFU and Erectile Dysfunction:

Li LY et al. Comparison of penile size and erectile function after high-intensity focused ultrasound and targeted cryoablation for localized prostate cancer: a prospective pilot study. Journal of Sexual Medicine 2010 Sep; 7(9): 3135-42

Mearini L, Porena M. Transrectal high-intensity focused ultrasound for the treatment of prostate cancer: past, present, and future. Indian Journal of Urology 2010 Jan-Mar; 26(1): 4-11

Warmuth M et al. Systematic review of the efficacy and safety of high-intensity focused ultrasound for the primary and salvage treatment of prostate cancer. European Urology 2010 Sept 17

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