title: Effect of low dose-rate prostate brachytherapy on the sexual health of men with optimal sexual function before treatment: analysis at > or = 7 years of follow-up.
abstract: OBJECTIVE
  To evaluate the effect of low-dose rate prostate brachytherapy on the sexual health of men with > or = 7 years of prospective evaluation and optimum sexual function before treatment.
  
  
  METHODS
  In all, 223 patients with T1b to T3a prostate cancer and a median (range) age of 66 (50-82) years were treated with permanent seed implantation from November 1990 to March 1998. They were followed for a median (range) of 8.2 (7-14.1) years using prospective quality-of-life measures. Erectile function (EF) was assessed using a physician-assigned score and beginning in June 2000; the validated International Index of EF (IIEF-5) was used as a complementary method to quantify late EF. No adjustment was made to differentiate sexual function with or with no pharmacological intervention for EF. Pearson's chi-square test and Student's t-test were used to compare the groups.
  
  
  RESULTS
  Of the 223 men, 131 (59%) had optimal EF before their brachytherapy; of these, 51 (40%) at the last follow-up evaluation were using either a phosphodiesterase type 5 inhibitor (44, 86%), yohimbine (two, 4%) or alprostadil (five, 10%). The age at implantation was highly predictive of current EF; 23 of 25 (92%) men aged 50-59 years had a current EF of > or = 2; those aged 60-69 and 70-78 years had an EF of > or =2 in 48/75 (64%) and 18/31 (58%) (P = 0.01). A current IIEF-5 score of > or = 16 also correlated highly with age at implant, i.e. 50-59, 16/25 (64%); 60-69, 20/75 (27%) and 70-78 years, 6/31 (19%) (P < 0.001).
  
  
  CONCLUSIONS
  Patients aged <60 years and with optimal EF before low-dose rate prostate brachytherapy have a very high probability of long-term EF.
authors.affiliation: Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY 10029, USA. jamie.cesaretti@mountsinai.org
authors.forename: Jamie A
authors.initials: JA
authors.lastname: Cesaretti
authors.forename: Johnny
authors.initials: J
authors.lastname: Kao
authors.forename: Nelson N
authors.initials: NN
authors.lastname: Stone
authors.forename: Richard G
authors.initials: RG
authors.lastname: Stock
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects*; D007172:Erectile Dysfunction / Q000188:drug therapy / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011788:Quality of Life
chemical_list: D010726:Phosphodiesterase Inhibitors