Pro-active approach to the diagnostics of prostate cancer leads not only to the stages shift, but primarily to the recognition of the diseases in younger-age categories. Unique biological behaviour of the prostate cancer is different from other solid tumours. Natural course of the disease (long doubling time and slow progression) enables the patient with hormonally dependant tumour long-term stabilization of the disease and survival. Every therapy of prostate cancer (surgical-, radiation- and drug therapies) shall significantly influence sexual life of the patients and thereby also the quality of their life. Material a methods: We present a group of 36 males with average age of 63.2 years <48;67> with locally advanced or generalised disease. Before commencement of the therapy all these men lived sexual life. Hormonal suppression had been incited with LH RH analogues or anti-androgens, in 29 men from the group in the form of intermittent androgenic suppression, others were receiving continual therapy. We were evaluating Life Quality Assessment Questionnaires and IIEF score (International Index of Erectile Function), therapeutic response and its duration. Results: Before commencement of the therapy we had diagnosed erectile dysfunction in 21 pts (59%) patients, ejaculation disorder in 50% and painful ejaculation in 11 pts (30%) of patients. Progress of the sexual dysfunction depended on the kind of pharmaceutical used. LH RH analogues lead to the quick loss of libido and development of impotence in majority of patients. Administration of steroid anti-androgens is not followed by development of sexual dysfunction, despite decrease of testosterone levels. We have observed libido decrease only in 25% of patients. Erectile dysfunction worsened in patients with already developed dysfunction. Non-steroid anti-androgens induced sexual dysfunction in 30% of patients. Intermittent androgenic suppression reduces incidence of symptoms associated with lack of androgens; in the cycle without therapy comes to the increase of testosterone levels and improvement of sexual life. Conclusion: Sexual dysfunction (SD) is accompanied with prostate diseases. Depending on the level of symptoms of lower urinary tract also the SD level gets worse. Moreover, in prostate cancer we influence development of SD also by selection of therapeutic regimen and anti-tumour pharmacotherapy. During selection of therapeutic strategy we should take into consideration not only safety of oncological therapy but also the patient’s sexuality and preferences.

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2. český a mezinárodní andrologický kongres, Štiřín, 3.-5.5.2007