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Most men’s ability to ejaculate retained after prostate cancer Brachytherapy

By Mark Cowen
06 May 2009

Int J Radiat Oncol Biol Phys 2009; 74: 126–132

MedWire News: Most men with prostate cancer retain their ability to ejaculate after undergoing brachytherapy, but they may experience reductions in volumes of ejaculate and a reduced ability to orgasm, French study findings indicate.

Brachytherapy is an effective treatment for localised prostate cancer that involves placing radioactive ‘seeds’ inside the tumour to kill cancer cells.

Writing in the International Journal of Radiation Oncology Biology Physics, Dr Eric Huyghe, from Centre Hospitalier Universitaire Rangueil in Toulouse, and team explain that the effects of prostate cancer treatment on erectile function have been widely studied. But they add that the impact of such treatments on ejaculatory function has only recently become a focus of attention.

To investigate the effects of brachytherapy on ejaculatory function, the researchers studied 241 sexually active men who received this form of treatment for localised prostate cancer. All the men completed a sexual health questionnaire designed to assess five aspects of ejaculation: frequency, volume, dry ejaculation, pleasure and pain.

The researchers found that although 81% of men had retained their ability to ejaculate an average of 36 months after undergoing brachytherapy, the proportion of patients with either no or only occasional ejaculations increased from 8% before treatment to 19% afterwards. Having rare or absent ejaculation after prostate brachytherapy was significantly associated with increased age and erectile function before treatment.

The proportion of patients with a reduction in their ejaculate volume or no ejaculate increased significantly from 26.1% and 2.9%, respectively, before treatment to 71.2% and 16.2%, respectively, afterwards. In addition, dry ejaculation increased from 0% before treatment to 18.7% after treatment, and the proportion of patients often or sometimes experiencing pain during orgasm increased from 12.9% to 30.3%.

Before treatment, just 1% of men achieved no orgasms, but this increased significantly to 10% after treatment. There was also a significant increase in the proportion of men who experienced late/difficult or weak orgasm.

The researchers conclude: “Our findings have shown that ejaculatory function is usually conserved in men sexually active before prostate brachytherapy, even though most described a reduction in the volume of ejaculate and a deterioration in orgasmic quality.”
They add that the findings may be useful for men considering treatment options for localised prostate cancer.