title: [Orgasm after curietherapy with permanent iodine-125 radioimplants for localized prostate cancer].
abstract: OBJECTIVE
  Orgasm is a domain of male sexuality that remains underreported in literature. Our aim was to realize the first detailed analysis of orgasm in patients treated by 125 I permanent prostate brachytherapy for localized prostate cancer.
  
  
  METHODS
  In a series of 270 sexually active men treated by prostate brachytherapy (125I permanent implantation), 241 (89%), mean age of 65 (43-80), participated in a mailed survey about sexual function after a mean time of 36 months (9-70). Erectile and ejaculatory functions and orgasm were explored using a mailed questionnaire. Two questions focused on orgasm. The first was about quality of orgasm (fast/intense/late, difficult/weak/absent) and the second about the presence of painful orgasm and its frequency (always/sometimes/often).
  
  
  RESULTS
  After prostate brachytherapy, 81.3% of sexually active men conserved ejaculation and 90% orgasm. There was a significant deterioration of the quality of orgasm (P=0.0001). More than 50% of the patients had an altered orgasm (weak, difficult, absent) after brachytherapy, vs 16% before implantation (P=0.001). Men with a diminished ejaculation volume often had a weak/difficult orgasm (P=0.007). Neoadjuvant hormonal therapy did not seem to impact the quality of orgasm or the frequency of painful ejaculation. Patients who had an IIEF-5 score higher than 12 had frequently intense orgasm (26.7% vs 2.7%; P<0.001) after brachytherapy. Sixty patients (30.3%) experienced often/sometimes painful ejaculation 12.9% (n=31) before implantation (P=0.0001).
  
  
  CONCLUSIONS
  Most of the patients treated by prostate brachytherapy conserved orgasm after treatment. However, most of the patients described a deterioration of the quality of orgasm.
authors: Département d'urologie-andrologie, CHU Rangueil, Toulouse cedex, France.
authors: B
authors: B
authors: Delaunay
authors: M
authors: M
authors: Delannes
authors: A
authors: A
authors: Salloum
authors: D
authors: D
authors: Delavierre
authors: F
authors: F
authors: Wagner
authors: F
authors: F
authors: Jonca
authors: M
authors: M
authors: Thoulouzan
authors: P
authors: P
authors: Plante
authors: J-M
authors: JM
authors: Bachaud
authors: M
authors: M
authors: Soulie
authors: E
authors: E
authors: Huyghe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000726:Androgen Antagonists / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001918:Brachytherapy / Q000009:adverse effects; D004542:Ejaculation / Q000528:radiation effects*; D007172:Erectile Dysfunction / Q000209:etiology; D019538:Health Care Surveys; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009948:Orgasm / Q000528:radiation effects*; D010146:Pain / Q000209:etiology; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D007457:Iodine Radioisotopes