Effect of low dose-rate prostate brachytherapy on the sexual health of men with optimal sexual function before treatment: analysis at ≥ 7 years of follow-up


  • This work was presented at 47th annual ASTRO annual meeting in October 2005.

Jamie A. Cesaretti, 1184 5th Avenue, Box 1236, Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY 10029, USA.
e-mail: jamie.cesaretti@mountsinai.org



To evaluate the effect of low-dose rate prostate brachytherapy on the sexual health of men with ≥ 7 years of prospective evaluation and optimum sexual function before treatment.


In all, 223 patients with T1b to T3a prostate cancer and a median (range) age of 66  (50–82) years were treated with permanent seed implantation from November 1990 to March 1998. They were followed for a median (range) of 8.2 (7–14.1) years using prospective quality-of-life measures. Erectile function (EF) was assessed using a physician-assigned score and beginning in June 2000; the validated International Index of EF (IIEF-5) was used as a complementary method to quantify late EF. No adjustment was made to differentiate sexual function with or with no pharmacological intervention for EF. Pearson’s chi-square test and Student’s t-test were used to compare the groups.


Of the 223 men, 131 (59%) had optimal EF before their brachytherapy; of these, 51 (40%) at the last follow-up evaluation were using either a phosphodiesterase type 5 inhibitor (44, 86%), yohimbine (two, 4%) or alprostadil (five, 10%). The age at implantation was highly predictive of current EF; 23 of 25 (92%) men aged 50–59 years had a current EF of ≥ 2; those aged 60–69 and 70–78 years had an EF of ≥2 in 48/75 (64%) and 18/31 (58%) (P = 0.01). A current IIEF-5 score of ≥ 16 also correlated highly with age at implant, i.e. 50–59, 16/25 (64%); 60–69, 20/75 (27%) and 70–78 years, 6/31 (19%) (P < 0.001).


Patients aged <60 years and with optimal EF before low-dose rate prostate brachytherapy have a very high probability of long-term EF.