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

Abstract

Abstract 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.