Short-term sexual function after prostate brachytherapy

Sexual function was evaluated in 34 patients with low-risk prostate cancer (PSA less than or equal to 10, Gleason score: less than or equal to6, clini cal stage T1/T2) undergoing brachytherapy in a phase III prospective random ized trial comparing iodine-125 (I-125) to palladium-103 (Pd-103). 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 <greater than or equal to> 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 documen ted in 26% (9/34), 15% (5/34), and 38% (13/34) of patients, respectively, b ut 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 o f postbrachytherapy impotence. All four impotent patients who used sildenaf il responded favorably. With a median follow-up of 13 months, 65% of patien ts undergoing prostate brachytherapy maintained sexual function without pha rmacologic support. Including sildenafil responses, 76.5% of patients susta ined erections sufficient for sexual intercourse. 2001 Wiley-Liss, Inc.