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Short‐term sexual function after prostate brachytherapy
Author(s) -
Merrick Gregory S.,
Wallner Kent,
Butler Wayne M.,
Lief Jonathan H.,
Sutlief Steven
Publication year - 2001
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.1028
Subject(s) - medicine , brachytherapy , urology , prostate cancer , orgasm , sexual function , prostate brachytherapy , prostate , neurovascular bundle , radiation therapy , surgery , sexual dysfunction , cancer
Sexual function was evaluated in 34 patients with low‐risk prostate cancer (PSA ≤ 10, Gleason score ≤ 6, clinical stage T1/T2) undergoing brachytherapy in a phase III prospective randomized trial comparing iodine‐125 ( 125 I) to palladium‐103 ( 103 Pd). The mean and median International Index of Erectile Function (IIEF) scores for the entire group were 14.2 and 16.5, respectively, and there was no difference between these scores when stratified by isotope. IIEF scores < 6, 6 to 11, and ≥ 12 were recorded in 35% (12/34), 6% (2/34), and 59% (20/34) of patients, respectively. Hematospermia, orgasmalgia (pain at the time of orgasm), and alteration in intensity of orgasm were documented in 26% (9/34), 15% (5/34), and 38% (13/34) of patients, respectively, but these side effects were of limited duration for most patients. There was no relationship between radiation dose to the neurovascular bundles (NVB), which averaged 209% of the prescribed prostate dose, and the development of postbrachytherapy impotence. All four impotent patients who used sildenafil responded favorably. With a median follow‐up of 13 months, 65% of patients undergoing prostate brachytherapy maintained sexual function without pharmacologic support. Including sildenafil responses, 76.5% of patients sustained erections sufficient for sexual intercourse. 2001 Wiley‐Liss, Inc.