The effect of therapeutic modalities on sexual potency is an important consideration for patients choosing a treatment for
prostate cancer. We assessed erectile function after
iridium-192 (1r-192) high-dose rate (HDR)
brachytherapy with external beam
radiation therapy (EBRT), and examined the efficacy of
sildenafil after this treatment. Forty-two
prostate cancer patients (T1c to T3bN0M0) were treated with 22Gy HDR
brachytherapy with 36.8Gy EBRT without neoadjuvant
hormone therapy. Erectile function was assessed using a 5-item version of the International Index of Erectile Function questionnaire (IIEF-5), pre, 3 and 12 months
after treatment, Potency was defined as an IIEF-5 score > or = 11. Ten patients with potency before HDR
brachytherapy with EBRT with or without neoadjuvant
hormone therapy requested
Sildenafil 3 months
after treatment. The mean IIEF-5 score of all patients was 10.5 +/- 8.5, 4.5 +/- 5.3 (p < 0.001), and 3.8 +/- 4.7 (p < 0.001), pre, 3 and 12 months
after treatment, respectively. Seventeen (40.4%) patients were potent before treatment. The mean IIEF-5 score of those patients was 15.8 +/- 3.2, 9.6 +/- 5.1 (p = 0.04), and 11.3 +/- 6.1 (p = 0.06), pre, 3 and 12 months
after treatment, respectively. Ten of 17 (58.8%) patients maintained their potency 12 months
after treatment. In 10 patients with potency before treatment who were treated with
sildenafil, the mean IIEF-5 score increased from 6.2 +/- 3.5 at 3 months to 13.6 +/- 5.1 (p < 0.001) at 12 months
after treatment. Eight of 10 (80%) patients treated with
sildenafil had recovered 12 months
after treatment. HDR
brachytherapy with EBRT can be performed with favorable results for maintaining potency.