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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.
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