Video: How Does HDR Brachytherapy Affect Sexual Function? | Ask a Prostate Expert, Dr. Jeffrey Demanes
Ask a Prostate Expert | Transcription
Alex: Okay, so you mentioned the two weeks of urinary irritation and all that. When it comes to sexual dysfunction, how long does that last? And when they do regain sexual function after a week or two, or whatever time frame you say, is it with Viagra, without Viagra, or is it just as they would go before?
Dr. Demanes: It varies and depends on the patient. If a patient comes in with no erectile dysfunction, age 55, chances are he'll be able to have an erection the next day. We tend to tell them not to have sexual activity for a week or two just to let things settle down, the acute urinary irritation, and they're probably not that excited about messing around down there any way at that point. Those guys, generally over the long term, do quite well in terms of preservation of sexual function, with or without medications. We do, however, offer all of the patients daily Cialis as a way to improve blood flow and to improve urinary flow after. We also, sometimes, will give Flomax or an alpha-blocker for improving urination in the immediate period in and around the time we do the implant.
When you get a patient who comes in with ED (erectile dysfunction) to begin with, then we generally don't make those patients better, but we try and at least preserve whatever function they have and they were more prone to put them on additional medications: Viagra, Levitra, to supplement Cialis and so forth, or refer that patient if they haven't already seen an erectile dysfunction specialist. But someone who comes in, you know, 75 years old with obesity and diabetes and heart disease and so forth, and erectile dysfunction, that typically isn't on the top of their list of concerns. But for the younger men and even those older guys who are still sexually active, we have, you know, a program and try and preserve sexual function to the extent possible, but there's always a risk that no matter how perfectly we do our job, they may lose sexual function. So they're always warned about the options, but, you know, the vast majority of my patients who we've treated who were functional before, are functional afterward. And, you know, there's that short period in between which is a bit of a hiatus which doesn't really mean too much—just an acute... You know, if you broke your arm you probably would want to let it rest for a little while, so…
Alex: Right. Now that makes sense, and the data obviously has shown that in those two studies you mentioned which is really cool.