INFLUENCE OF TRANSURETHRAL RESECTION ON SEXUAL DYSFUNCTION IN PATIENTS WITH PROSTATE-CANCER

Objective To evaluate retrospectively the potential influence of disea se-related factors and transurethral resection of the prostate (TURF) on the sexual function of patients who had undergone curative radiothe rapy for prostate cancer. Patients and methods The study comprised 104 patients (median age 69.5 years, range 49-81) who had been treated wi th curative radiotherapy and no first-line hormones: 16, 52, 33 and th ree patients had T1, T2, T3 and T4 tumours, respectively. TURF was per formed in 73 patients before RT, and needle biopsy alone in 31 patient s. They were interviewed about their past and present sexual lives usi ng a questionnaire designed to evaluate the potency of the patients at age 45 years, at 1 year before the diagnosis of the disease, before r adiotherapy (after TURF or needle biopsy) and at the last follow-up. I nformation concerning associated diseases, routine medication and the weight of the resected material was also collected. Results Before dia gnosis, 20 patients had no erections while 84 were potent. Of the 60 p otent patients undergoing a TURF, 31 (51%) indicated complete impotenc e immediately thereafter. There was no statistical difference between impotent and potent patients after TURF in age, associated diseases, m edical treatment and the weight of the resected material. Conclusion T URF may lead to impotence in a significant proportion of patients. As TURF is an important component of 'conservative' treatment approaches, its potential sexual morbidity should be taken into consideration in the comparative risk-benefit analysis of different therapeutic strateg ies.