This work was presented at 47th annual ASTRO annual meeting in October 2005.
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
Article first published online: 4 JUL 2007
Volume 100, Issue 2, pages 362–367, August 2007
How to Cite
Cesaretti, J. A., Kao, J., Stone, N. N. and Stock, R. G. (2007), 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. BJU International, 100: 362–367. doi: 10.1111/j.1464-410X.2007.07016.x
- Issue published online: 4 JUL 2007
- Article first published online: 4 JUL 2007
- Accepted for publication 16 February 2007
- prostate brachytherapy;
- prostate cancer;
- erectile dysfunction;
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.
PATIENTS AND METHODS
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.