title: The impact of prostatectomy and brachytherapy in patients with localized prostate cancer.
abstract: OBJECTIVE
  to compare urinary incontinence and erectile dysfunction symptoms reflecting quality of life and the willingness to undergo treatment again in patients treated by radical retropubic prostatectomy and low dose radiation (LDR) brachytherapy.
  
  
  METHODS
  from July 1992 to November 2001, 158 patients with clinical localized prostate cancer were treated by radical retropubic prostatectomy with or without nerve sparring or LDR brachytherapy. To all the 158 patients we mailed a self-reporting questionnaire with 5 questions to access sexual function, 4 questions for urinary continence, and 2 for the satisfaction with the treatment and willingness to undergo treatment again. Patients had no form of adjuvant radiation therapy, or neoadjuvant or adjuvant androgen suppression therapy. A total of 56 patients (43%), 34 of the prostatectomy and 22 patients of the brachytherapy group answered the questionnaire. Questionnaire results were independently analyzed by someone else not involved with patients' treatment.
  
  
  RESULTS
  patients self-reported some degree of erectile dysfunction in 84.8% (p = 0.01) in the group treated by prostatectomy and 23.07% (p = 0.86) in the brachytherapy group. Urinary incontinence occurred in 17.6% in the group treated by prostatectomy (p = 0.01) and in 9.5% (p = 0.52) in the brachytherapy group. Urinary incontinence and impotence significantly affected treatment satisfaction. However, considering satisfaction with the treatment and willingness to undergo treatment again, 88.2% of patients would elect surgery again and 95.5% brachytherapy again.
authors.affiliation: Division of Urology Hospital Beneficência Portuguesa de São Paulo, Brazil.
authors.forename: Felipe
authors.initials: F
authors.lastname: Reis
authors.forename: Nelson Rodrigues
authors.initials: NR
authors.lastname: Netto
authors.forename: José Alberto S
authors.initials: JA
authors.lastname: Reinato
authors.forename: Marcelo
authors.initials: M
authors.lastname: Thiel
authors.forename: Emerson
authors.initials: E
authors.lastname: Zani
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects*; D007172:Erectile Dysfunction / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000628:therapy*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000209:etiology