Introduction. The incidence of erectile dysfunction (ED) after prostate cancer tretment can reach 50% within 5 years. Since low dose rate brachytherapy (LDRBT) is one of the treatment options for prostate cancer (РСа), it is important to assess the patient's initial sexual profile in order to monitor and manage its progress after the procedure.
The aim of the study was to assess the sexual constitution of patients with localised prostate cancer.
Materials and methods. The study included 150 patients with stage T1C-2a N0 M0 РСа, with a median age of 65 years [55; 75]. Patients underwent a standard set of examinations according to clinical guidelines for the diagnosis and treatment of РСа. All patients completed questionnaires: the International Index of Erectile Function (IIEF-5), the AMS (Male Aging Questionnaire), and the Rostov Questionnaire for the Integral Assessment of Male Sexuality (since 2009).
According to the AMS scale, 28 (19%) patients have no symptoms of aging; 86 (57%) have mild symptoms; 23 (15%) have moderate symptoms; and 13 (9%) men have severe symptoms. 148 (98.7%) patients with PCa subject to LDRBT are classified as hyposexual, and only 2 (1.3%) patients are classified as normosexual. Mild hyposexuality (46–67 points) was detected in 68 (45%), moderate (23–46 points) – in 72 (48%), and severe (0–22 points) – in 10 (7%) respondents. According to the IIEF-5 questionnaire, 19 (12.7%) patients had severe ED; 32 (21.3%) – moderate ED; In 65 (43.3%) patients, it was mild; and in 34 (22.7%) patients, ED was absent. Thus, a statistically significant relationship between the scores of the male sexuality scales, IIEF-5, and AMS was practically absent and was not statistically confirmed. When assessing the relationship between the AMS, IIEF-5 and male sexuality gradations, no statistically significant relationships were found using the chi-square test.
Conclusion. The sexual constitution of most men with PCa who have undergone LDRBT is characterized by hyposexual activity throughout their sexual life. There is an urgent need for an integrated assessment of male sexuality early in the diagnosis of patients with PCa who subsequently undergo LDRBT to evaluate the results of penile rehabilitation, taking into account the initial status of sexual function before brachytherapy.
