Impact of age on sexual preservation after prostate brachytherapy: A prospective evaluation in men without erectile dysfunction.

Abstract

105 Background: Sexual preservation is an important issue in the treatment of localized prostate cancer. In this study, we evaluate the long-term incidence of erectile dysfunction (ED) after prostate brachytherapy (PBT), in men without ED. Methods: Between 2006 and 2012, prospective data of patients treated with brachytherapy for a low or intermediate-risk prostate cancer (d’Amico classification), were collected. Erectile function (EF) was assessed with IIEF5 score (5-Item Version of the International Index of Erectile Dysfunction) at six weeks and then every year during the follow-up. No ED was defined by an IIEF5 score ≥ 22/25 and a mild ED by a score between 17 and 21. Results: Up to this point, 70 patients, with an initial IIEF5 ≥22, were analyzed with a mean follow-up of 46.5 months. At 6 weeks and 1, 2, 3 and 4 years after brachytherapy, mean IIEF5 scores in all 70 patients were 24.6, 21.3, 19.7, 19.1 and 17.3, respectively. In ≤ 65 years old group, the scores were 24.7, 20.9, 21.3, 21.1, 19.7 and 20, respectively. In > 65 years old group, the scores were 24.6, 21.8, 21.3, 18.1, 18.2 and 14.9, respectively. The evaluation of ED according to age groups is represented in the table. Conclusions: At 4 years of follow-up after brachytherapy, patients 65 years old and younger have an EF preservation rate >80% with 50% of them having no ED. For patients older than 65 years, the rate of EF preservation decreased at 50% after 4 years of follow up with only few of them having no ED. This difference between the 2 groups of age is probably more related to an age effect than a brachytherapy toxicity. At the time of the meeting, more data and results will be available. [Table: see text]