The NC ProCESS Study

In this single-center study, telephone surveys were conducted at baseline and at 3, 12, and 24 months after the treatment date. Of 1141 men enrolled, 27.5% underwent active surveillance, 21.8% underwent EBRT, 9.6% underwent brachytherapy, and 41.1% underwent prostatectomy.

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For sexual dysfunction, patients who received EBRT and brachytherapy had increased sexual dysfunction compared with active surveillance, though the differences were not clinically significant. Of men with normal function at baseline, 57.1% reported poor function at 24 months after prostatectomy, 27.2% after EBRT, 34.2% after brachytherapy, and 25.2% after active surveillance. Men with poor function at baseline maintained poor function at 24 months.

The effect on urinary obstruction and irritation was greatest in men who received brachytherapy and EBRT at 3 and 12 months, but not at 24 months. For patients with normal function at baseline, 52.7% remained normal at 24 months after prostatectomy, 48.8% after EBRT, and 19.3% after brachytherapy. Among patients with poor function at baseline, there was improvement in between 45% and 50% of men after EBRT, brachytherapy, and active surveillance.

For urinary incontinence, the scores were not significantly different for men undergoing EBRT or brachytherapy vs active surveillance at 3, 12, and 24 months. For men with normal control at baseline, 34.3% remained normal at 24 months after prostatectomy and 15.8% reported poor control; normal function was maintained at 24 months in 73.0% of men after EBRT, in 64.8% of men after brachytherapy, and in 72.7% of men after active surveillance.

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For bowel problems, between approximately 40% and 60% of men with normal function at baseline maintained normal levels at 24 months. In 17% of men who received EBRT, however, bowel function worsened to a poor function 24 months. Poor bowel function was reported by 5.6% of men receiving prostatectomy and 9.3% of men receiving active surveillance.