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  • Cancer de la Prostate
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Troubles sexuels après curiethérapie par implants permanents d’I-125 dans le cancer localisé de prostate

Sexual disorders after brachytherapy by permanent I-125 implants in localized prostate cancer

Andrologie volume 13, pages 252–258 (2003)Cite this article

Resume

La curiethérapie par implants permanents est une alternative à la prostatectomie radicale ou à l’irradiation externe en cas de cancer localisé de la prostate de bon pronostic. Les avantages de ce traitement sont une irradiation efficace mais précise, limitée à la glande prostatique avec une morbidité modérée et passagère. Les troubles de l’érection fréquents après chirurgie et irradiation externe sont retrouvés dans 6 à 61% des cas dans la littérature après curiethérapie. De tels écarts entre ces taux sont liés aux différences en terme de suivi, de définitions des troubles sexuels, d’instruments de mesure utilisés. Ces troubles de l’érection apparaissent entre 9 et 17 mois et seraient liés aux lésions radiques vasculaires des corps érectiles proches de l’apex prostatique (bulbe urétral et base des corps caverneux). Cependant, la majorité des troubles de l’érection répondent favorablement au traitements oraux tels que la yohimbine ou le sildénafil.

Parmi les options thérapeutiques à visée curative du cancer localisé de prostate, la curiethérapie par implants permanents est le traitement qui préserve le mieux la fonction érectile.

Abstract

Brachytherapy by permanent implants is an alternative to radical prostatectomy or external beam radiotherapy for good prognosis localized prostate cancer. The advantages of this treatment are effective and precise irradiation, limited to the prostate gland with moderate and transient morbidity. Erectile dysfunction, frequent erection after surgery and external beam radiotherapy, is observed in 6% to 61% of cases in the literature after brachytherapy. This wide range is related to differences in terms of follow-up, definition of sexual disorders, and the measuring instruments used. These erectile disorders occur between 9 and 17 months after treatment and appear to be related to vascular radiation lesions of the erectile bodies close to the prostatic apex (urethral bulb and base of the corpora cavernosa). However, the majority of erectile disorders respond favourably to oral treatments such as yohimbine or sildenafil.

Among the various curative treatment options for localized prostate cancer, permanent implant brachytherapy is the treatment ensuring the best preservation of erectile function.

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Authors and Affiliations

  1. Service d’Urologie, Hôpital Salvator, 249 boulevard Sainte-Marguerite, B.P. 51, 13274, Marseille cedex 09

    Franck Bladou, Gilles Karsenty & Gérard Serment

  2. Département de Radiothérapie, Institut Paoli-Calmettes, Marseille

    Naji Salem & Michelle Simonian

  3. Département d’Oncologie Médicale, Institut Paoli-Calmettes, Marseille

    Gwenaelle Gravis

  4. Département de Radiologie, Institut Paoli-Calmettes, Marseille

    Roland Rosello

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  1. Franck Bladou
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  2. Naji Salem
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Correspondence to Franck Bladou.

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Bladou, F., Salem, N., Karsenty, G. et al. Troubles sexuels après curiethérapie par implants permanents d’I-125 dans le cancer localisé de prostate. Androl. 13, 252–258 (2003). https://doi.org/10.1007/BF03034879

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Basic and Clinical Andrology

ISSN: 2051-4190