SEXUAL FUNCTION AFTER PERMANENT SEED IMPLANT PROSTATE BRACHYTHERAPY

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  • Yagi Yasuto
    The Department of Urology, National Hospital Organization Tokyo Medical Center
  • Namitome Ryo
    The Department of Urology, National Hospital Organization Tokyo Medical Center
  • Kono Yuho
    The Department of Urology, National Hospital Organization Tokyo Medical Center
  • Nishiyama Toru
    The Department of Urology, National Hospital Organization Tokyo Medical Center
  • Toya Kazuhito
    Department of Radiation Oncology, National Hospital Organization Tokyo Medical Center
  • Yorozu Atsunori
    Department of Radiation Oncology, National Hospital Organization Tokyo Medical Center
  • Saito Shiro
    The Department of Urology, National Hospital Organization Tokyo Medical Center

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Other Title
  • 前立腺癌永久挿入小線源療法後における性機能の長期成績
  • ゼンリツセンガン エイキュウ ソウニュウ ショウセン ゲン リョウホウ ゴ ニ オケル セイ キノウ ノ チョウキ セイセキ

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Abstract

(Purpose) The aim of this study was to evaluate the long-term effects of permanent seed implant prostate brachytherapy (BT) on sexual function (SF). (Materials and methods) From September 2003 to July 2005, 56 patients underwent radical retropubic prostatectomy (RRP) without any hormone therapy, while 353 patients had undergone BT without any adjuvant hormone therapy in a single institute. Out of these 353 patients in the BT group, 305 patients received neoadjuvant hormone therapy (BT NHT+group), while 48 did not (BT NHT-group). SF was prospectively evaluated using the UCLA Prostate Cancer Index (UCLA-PCI). Potency was defined as the UCLA-PCI Q26 point of≥3. (Result) The preimplant UCLA-PCI scores of SF for BT NHT-and BT NHT+groups were 50.9 and 13.4, respectively. The SF score of the NHT-group post operatively decreased to 38.9 within 6 months, but was maintained at the same level after that. With the recovery of the androgen, SF score of the NHT+group improved after BT: however, it did not reach up to that of the NHT-group. In the univariate analysis, patient's age was the only predictive factor for SF after BT. Thirty-four out of 48 patients in the BT NHT-group and 23 out of 56 patients in the RRP group showed adequate potency before surgery. Their 5-year potency preservation rate was 73.6%in the BT NHT-group and 4.3%in the RRP group. (Conclusion) SF slightly decreased immediately after BT but was usually maintained during the course observation for 5 years. The 5-year SF preservation rate after BT was 73.6%.

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