¹Department of Urology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

Correspondence: N Mabjeesh, Department of Urology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv 64239, Israel. E-mail: nicolam@tasmc.health.gov.il

Received 10 March 2004; Revised 8 September 2004; Accepted 22 September 2004; Published online 21 October 2004.

Abstract

We prospectively assessed patients' erectile function (EF) using the International Index of Erectile Function (IIEF) and a global assessment questionnaire (GAQ) following permanent ¹²⁵I-brachytherapy for localized prostate cancer. Of 378 treated patients, 220 had a minimal 2-y follow-up and 131/220 were sexually active prior to brachytherapy, with an EF domain score of 11 (study group). Patients were allowed sildenafil at any time of the study. The patients' mean EF score, without excluding patients who used sildenafil, dropped within 3 months after brachytherapy, recovered at the end of the first year and remained unchanged for at least up to 2 y after treatment regardless of the addition of neoadjuvant hormone therapy to ¹²⁵I-brachytherapy. Analysis of the GAQ revealed that 80% of the patients were satisfied with their sexual function up to 3 y after treatment. Any detrimental effect of permanent brachytherapy with or without the addition of hormone therapy on EF is reversible, and recovery is expected at 1 y after treatment in most patients.