**5. Conclusion**

#### **5.1 QOL**

RRP and interstitial brachytherapy continuously decreased health-related QOL. External beam radiotherapy for localized prostate cancer aggravates the bowel function. Healthrelated QOL was significantly improved in patients treated with HIFU therapy at 24 months after HIFU.

### **5.2 Urinary function**

Urinary incontinence is the most prominent side effect of radical prostatectomy. But, RALP might improve incontinence rates of patients. The urinary function of patients after brachytherapy and cryotherapy were similar. In HIFU, however maximum flow rate and residual urine volume were significantly impaired at 6 months after treatment, and data on maximum flow rate and residual urine volume recovered to baseline at 12, 24 months after HIFU.

#### **5.3 Erectile function**

Generally, potency rate was aggravated by injury to NVB after radical prostatectomy. Consequently, using RALP to preserve the NVB and prostatic fascia is important for preserving erectile function. Approximately 40% of patients in the external and interstitial brachytherapy groups preserved their pretreatment sexual status. In cryoablation, 3.7% and 14.3% of patients had partial erections at 6 weeks and 9 months after treatment. And, 21% and 24% of the patients had regained full potency at 18 and 24 months after cryosurgical ablation. After HIFU, 52%, 63% and 78% of patients who did not undergo NADT had regained full potency at 6, 12, and 24 months after treatment therapy. Furthermore, the potency rates were 39%, 62%, and 67% at 6, 12, and 24 months, respectively, without the use of PDE5 inhibitors. HIFU therapy can, therefore, preserve erectile function better than RRP, radiotherapy, or cryotherapy.
