Department of Urology, Keio University School of Medicine, Tokyo, Japan.
J Urol. 2013 Mar;189(3):1014-8. doi: 10.1016/j.juro.2012.09.086. Epub 2012 Sep 24.
Few studies have evaluated changes in erectile function with time before and after prostate brachytherapy using the International Index of Erectile Function-15, a sensitive, validated tool for assessing male sexual dysfunction. In this prospective study we evaluated the natural history of erectile function after prostate brachytherapy without supplemental therapy (external beam radiotherapy, phosphodiesterase-5 inhibitors or androgen deprivation therapy) using the International Index of Erectile Function-15.
We identified 119 patients who were followed at least 12 months after prostate brachytherapy between 2004 and 2010. Sexual and erectile function status were assessed before brachytherapy (baseline), and 3, 6, 12, 18, 24 and 36 months postoperatively using the International Index of Erectile Function-15.
Mean total International Index of Erectile Function-15 score, and scores on the erectile function, orgasmic function, sexual desire and intercourse satisfaction domains 3 months after brachytherapy were significantly lower than at baseline (p <0.05). They remained lower until 36 months after prostate brachytherapy. Erectile function was maintained 12 months after brachytherapy in 16 of the 48 men (33.3%) with a baseline erectile function domain score of 11 or greater. There was no significant difference in clinical features except the age of patients who maintained the erectile function domain score and their counterparts 12 months after brachytherapy. Multivariate analysis revealed that age 70 years or greater was the only predictive factor for deteriorating erectile function after brachytherapy (p = 0.035).
Findings indicate a global decrease in all domains of the International Index of Erectile Function-15 score 12 months after prostate brachytherapy. Also, patient age may influence the preservation of brachytherapy related potency.
很少有研究使用国际勃起功能指数-15（一种评估男性性功能障碍的敏感、有效的工具）评估前列腺近距离放射治疗前后勃起功能随时间的变化。在这项前瞻性研究中，我们使用国际勃起功能指数-15 评估了前列腺近距离放射治疗后（未接受补充治疗，如外照射放疗、磷酸二酯酶-5 抑制剂或雄激素剥夺治疗）无勃起功能障碍的自然史。
我们确定了 2004 年至 2010 年间接受前列腺近距离放射治疗后至少随访 12 个月的 119 例患者。使用国际勃起功能指数-15 在近距离放射治疗前（基线）、术后 3、6、12、18、24 和 36 个月评估性功能和勃起功能状态。
与基线相比，术后 3 个月时国际勃起功能指数-15 的总分以及勃起功能、性高潮功能、性欲和性交满意度评分显著降低（p<0.05）。直到前列腺近距离放射治疗后 36 个月，这些评分仍较低。在基线勃起功能域评分为 11 或更高的 48 例患者中有 16 例（33.3%）在近距离放射治疗后 12 个月时仍保持勃起功能。除了年龄外，两组患者在临床特征上无显著差异。多变量分析显示，年龄 70 岁或以上是近距离放射治疗后勃起功能恶化的唯一预测因素（p=0.035）。
研究结果表明，前列腺近距离放射治疗后 12 个月，国际勃起功能指数-15 评分的所有域值均降低。此外，患者年龄可能影响近距离放射治疗相关勃起功能的维持。
