Aims: Erectile dysfunction (ED) is the most prevalent sexual consequence of prostate cancer (PCa) treatment, significantly affecting the quality of life of patients and their partners. Despite advances in pharmacological and surgical interventions, progress has plateaued. To address this, we convened an international multidisciplinary workshop to evaluate the current landscape of PCa-related ED and develop consensus statements to guide the field forward.
Methods: Twenty experts spanning urology, sexual and lifestyle medicine, survivorship care and basic science attended a one-day, three-phase consensus process, deliberating in-person and asynchronously via a digital platform (Howspace). Phase 1 established shared understanding of the current clinical and research landscape; Phase 2 used individual and small-group ideation to identify thematic priorities; and Phase 3 developed and prioritised consensus statements in small multidisciplinary groups. Statements were rated on a 5-point Likert scale for accuracy in reflecting group discussion, with iterative feedback incorporated until alignment was reached.
Results: Five consensus statements were endorsed, with final scores of 4.1-4.6/5.0 indicating strong group endorsement. All five aligned on one theme: the heterogeneity of the PCa population and the inadequacy of standardised, one-size-fits-all care. They addressed: advancing the clinical trials agenda for PCa-related ED; targeted biomedical and preclinical research; embedding personalised lifestyle-centred care; strengthening patient and partner support and education; and harnessing artificial intelligence for integrated, personalised care. Together, the statements map a research and practice agenda spanning the translational continuum, from basic biology to care delivery.
Conclusions: These consensus statements provide a framework for research and clinical practice in PCa-related sexual health care. The structured process did more than produce an agenda: it connected fields that have advanced in isolation and built shared ownership across disciplines. Progress now depends on coordinated investment and sustained collaboration, placing the sexual wellbeing of PCa survivors and their partners at the centre of survivorship care.