Erectile Dysfunction Among Testicular Cancer Survivors: A Systematic Review and Meta-Analysis, 2020

Abstract Background: Erectile dysfunction is one of the common complications of testicular cancer with the prevalence of 11.3% to 84%. It has devastating effects on men and partner’s quality of life, sexual satisfaction, and sexual experience. The findings of the previous studies on this matter were uneven and inconsistent. Therefore, this systematic review and meta-analysis is conducted in order to acquire a more recent and comprehensive result. Methods and materials: PubMed, Scopus, Goggle scholar, Science Direct, African Index Medicus, African Journal online, EMBASE, and Cochrane Library databases were searched. All necessary data were extracted using a standardized data extraction format. Data were analyzed using STATA 14 statistical software. A heterogeneity of studies was assessed using the I 2 statistics. Publication bias was checked by using a funnel plot and Egger's regression test. A random-effect model was computed to estimate the pooled prevalence of erectile dysfunction. Result: Fourteen full-text studies were included in this systematic review and meta-analysis. The pooled prevalence of erectile dysfunction among testicular cancer survivors was found to be 34.60% (95% CI: 25. 89, 43.30% [I 2 = 95.9%, p = 0.000]). Study design subgroup analysis indicated that the pooled prevalence of erectile dysfunction was 50.02% (95% CI: 22.78, 77.28% [I 2 = 96.1, p = 0.000]) and 27.36. % (95% CI: 19.23, 34.48% [I 2 = 91.6, P = 0.000]) in the case control and cohort studies respectively. Likewise, the level of erectile dysfunction was varied based on erectile dysfunction measuring tools and testicular cancer treatment modalities. Conclusion: The pooled prevalence of erectile dysfunction in testicular cancer survivors was found to be high. It had also a considerable discrepancy between the study designs, and measuring 3 tools and treatment modalities of testicular cancer. Therefore, there is a sound to diminish the high burden of this problem.