The effect on erectile function of 103palladium implantation for localized prostate cancer.

OBJECTIVE To determine in a prospective study the effect on erectile function of 103Pd brachytherapy for localized prostate cancer, using a validated questionnaire. PATIENTS AND METHODS Between July 1999 and April 2003, 113 men with localized prostate cancer were treated by permanent implantation of 103Pd seeds, of whom 78 with a follow-up of 30 months were included in this study. No patient received supplemental external beam radiation therapy. At baseline and 3-month intervals, erectile function (EF) was assessed by the EF domain score of the International Index of Erectile Function-15 (IIEF-15); 77% received (neo)adjuvant antiandrogen therapy for up to 3 months. RESULTS At baseline, 27 (35%) patients had no erectile dysfunction (ED; EF domain score 26–30), 24 (31%) had mild/moderate ED (score 11–25) and 27 (35%) severe ED (score 6–10). The mean EF domain score decreased from 17 to 12 (P   0.05). CONCLUSIONS There was a high prevalence of pre-existing ED in these men; 57% of men fully potent or with mild ED at baseline remained so 30 months after brachytherapy.