**4. Erectile function**

358 Prostate Cancer – Diagnostic and Therapeutic Advances

comparable to baseline, but sexual domains remained well below baseline at 12 months follow-up and compared to brachytherapy, cryotherapy results in less irritative and obstructive voiding systems in the early post-treatment period, and may improve the

We reported QOL after HIFU for localized prostate cancer.11 In our report the total FACT score significantly improved at 24 months, and Physical well-being factor(at 6 and 12 months after HIFU therapy) and Functionalwell-being factor (at 24 months after HIFU therapy) in FACT-G showed significant improvements. Further analysis of the elements of FACT-G showed such responses as "I am bothered by the side-effects of treatment" (at 12 months after HIFU therapy), "I am able to enjoy life" (at 24 months afterHIFU therapy) and "I have accepted my illness" (at 24 months after HIFU therapy) to have all statistically

Urinary incontinence is the most prominent side effect of radical prostatectomy. Urinary incontinence after treatment for localized prostate cancer is caused by sphincter malfunction. So, several technical modifications of open, laparoscopic and robot-assisted laparoscopic radical prostatectomy have been advocated to improve early and late urinary

Pardo *et al.* reported that urinary incontinence rates of patients treated with non-nerve sparing RRP and nerve sparing RRP were 69% and 54%.12 It has recently been demonstrated that reconstruction of the posterior aspects of the rhabdoshincter allows a rapid recovery of continence after retropubic radical prostatectomy and laparoscopic radical prostatectomy.13 But, Joshi *et al.*reported that there was no significant difference in early urinary incontinence between the group for which the posterior aspects of the rhabdoshincter were reconstructed and the group for which they were not reconstructed in cases of RALP.14 They suggested the reason why there was no significant difference was a magnified stereoscopic view and/or the finer, more maneuverable instruments in robot system may allow better preservation of sphincter supporting musculature, hence improving continence, and may obviate the

Di Pierro *et al.* compared continence rate between groups of patients treated with RRP and RALP, and reported that the continence rate of the RALP group was significantly higher than the RRP group at 3 and 12 months after RALP.15 Wang *et al.* reported that continence was achieved in 82%, 87%, and 91% of men at 3, 6, and 12 months after RALP.16 They also reported that the mean IPSS scores of these patients preoperatively and 3, 6, and 12 months after surgery were 14.1, 5.2, 3.0, and 2.9 and corresponding mean QOL scores were 3.4, 2.1,

Sanda *et al.*reported that 18% of patients in the brachytherapy group, 11% of those in the radiotherapy group, and 7% of those in the prostatectomy group had moderate or worse distress from overall urinary symptoms at 1 year.17 Pardo *et al.* reported that compared to the brachytherapy group, the prostatectomy group showed a greater deterioration of

**3.2 Urinary function after radiation therapy, cryotherapy, and HIFU** 

urinary incontinence but better urinary irrigative-obstructive results.12

**3. Urinary function after treatment for localized prostate cancer** 

urinary function for up to 24 months after treatment.10

**3.1 Urinary incontinence after radical prostatectomy** 

advantages of posterior reinforcing sutures.

improved.

incontinence.

1.6, and 1.6.13

It is important to preserve erectile function during treatment of prostate cancer. Postoperative potency depends on the preservation of neurovascular bundles (NVB), which are some times affected by tumor invasion.

Hanlon *et al.* reported a normal potency rate at 1 year after treatment of 50% for patients in the RRP group, 65% for patients in the brachytherapy group, and 69% for patients in the radiotherapy group.17
