Sexual function following treatment of localised prostate cancer with HDR-Ir-192 brachytherapy combined with external beam radiotherapy

Background: Clinically localised prostate cancer can be treated with various modalities after which there are a comparable overall survival. In this study the sexual function and quality of life was evaluated in patients treated with brachytherapy combined with external beam radiotherapy (EBRT). Patients and methods: One hundred and eleven patients with clinically localised prostate cancer were treated with HDR-Ir-192 brachytherapy in combination with EBRT from February 2000 to August 2003. An interview was conducted consisting of a questionnaire based on the International Index of Erectile Function (IIEF) and the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30, concerning erectile function and quality of life. Results: One hundred and three (96%) men consented for interview. The mean time following treatment was 28 months (range 6-36). Thirty-six men (35%) had normal erections at the time of interview, 23 men (22%) had no erections, 25 (25%), had variable erections whilst sexually active. Thirty men (29%) had had successful penetrative sexual intercourse in the 4 weeks preceding the interview each time they had attempted to do so. A further 15 (15%) had mostly successful penetration whenever they had tried during the previous 4 weeks. Nine (9%) had been unable to achieve penetration and 45 men (44%) had made no attempt at penetration. Importantly, 81 men (79%) indicated that their sexual function overall was reduced in comparison to the situation before treatment. Twenty-two men (21%) stated that their sexual function was unchanged and no man found that there had been an improvement as compared to pre-treatment. Conclusion: A reasonable number of men (60%) had erections of variable quality at the time of interview following treatment. However, 79% of men stated that their overall level of sexual function was reduced post-treatment. We have insufficient comparative baseline data to enable us to make a direct comparison between pre- and post-treatment sexual function. Patients rated their general level of health and quality of life as good following treatment.

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