Ejaculatory Function After Permanent ¹²⁵I Prostate Brachytherapy for Localized Prostate Cancer

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• 作者：Eric Huyghe ; Martine Delannes ; Fabien Wagner ; Boris Delaunay ; Joe Nohra ; Matthieu Thoulouzan ; J. Yeung Shut-Yee ; Pierre Plante ; Michel Soulie ; Patrick Thonneau ; Jean Marc Bachaud
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2009
• 出版时间：1 May 2009
• 年：2009
• 卷：74
• 期：1
• 页码：126-132
• 全文大小：113 K

文摘

Purpose

Ejaculatory function is an underreported aspect of male sexuality in men treated for prostate cancer. We conducted the first detailed analysis of ejaculatory function in patients treated with permanent ¹²⁵I prostate brachytherapy for localized prostate cancer.

Patients and Methods

Of 270 sexually active men with localized prostate cancer treated with permanent ¹²⁵I prostate brachytherapy, 241 (89 % ), with a mean age of 65 years (range, 43–80), responded to a mailed questionnaire derived from the Male Sexual Health Questionnaire regarding ejaculatory function. Five aspects of ejaculatory function were examined: frequency, volume, dry ejaculation, pleasure, and pain.

Results

Of the 241 sexually active men, 81.3 % had conserved ejaculatory function after prostate brachytherapy; however, the number of patients with rare/absent ejaculatory function was double the pretreatment number (p < .0001). The latter finding was correlated with age (p < .001) and the preimplant International Index of Erectile Function score (p < .001). However, 84.9 % of patients with maintained ejaculatory function after implantation reported a reduced volume of ejaculate compared with 26.9 % before (p < .001), with dry ejaculation accounting for 18.7 % of these cases. After treatment, 30.3 % of the patients experienced painful ejaculation compared with 12.9 % before (p = .0001), and this was associated with a greater number of implanted needles (p = .021) and the existence of painful ejaculation before implantation (p < .0001). After implantation, 10 % of patients who continued to be sexually active experienced no orgasm compared with only 1 % before treatment. in addition, more patients experienced late/difficult or weak orgasms (p = .001).

Conclusion

Most men treated with brachytherapy have conserved ejaculatory function after prostate brachytherapy. However, most of these men experience a reduction in volume and a deterioration in orgasm.