Management of sexual dysfunction after prostate brachytherapy.
Erectile dysfunction is a common sequela following potentially curative local treatment for early-stage carcinoma of the prostate gland. With larger studies and longer follow-up, it is clear that erectile dysfunction following prostate brachytherapy is more common than previously reported, with a myriad of previously unrecognized sexual symptoms. Approximately 50% of patients develop erectile dysfunction within 5 years of implantation. Several factors including preimplant potency, patient age, the use of supplemental external-beam irradiation, radiation dose to the prostate gland, radiation dose to the bulb of the penis, and diabetes mellitus appear to exacerbate brachytherapy-related erectile dysfunction. The majority of patients with brachytherapy-induced erectile dysfunction respond favorably to sildenafil citrate (Viagra). Despite reports questioning the potency-sparing advantage associated with brachytherapy, recent elucidations of brachytherapy-related erectile dysfunction may result in refinement of treatment techniques, an increased likelihood of potency preservation, and ultimately, improved quality of life.
Merrick
Gregory S
GS
Schiffler Cancer Center Wheeling, West Virginia, USA. schifonc@wheelinghosp.com
Wallner
Kent E
KE
Butler
Wayne M
WM
D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001918:Brachytherapy / Q000009:adverse effects*; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010879:Piperazines / Q000627:therapeutic use*; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011687:Purines; D000068677:Sildenafil Citrate; D013450:Sulfones; D014665:Vasodilator Agents / Q000627:therapeutic use*
D018931:Antineoplastic Agents, Hormonal; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate