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Jerry Hardy, 57, of Detroit had nerve-sparing surgery for prostate cancer in 2000 and lost sexual function. It took three years of trying different pills and injections before he decided on a penile implant, which has worked for him and his wife. He’s not sure whether having a better prediction method for future sexual function would have meant anything to him _ even with all he’s been through.

“The most important thing was to cure the cancer. Then we would deal with the side effects later,” Hardy said. “If you’re not alive, you don’t have to worry about sex.”

Jonathon Alsop, 54, of Boston was diagnosed with prostate cancer last year. His surgeon, study co-author Sanda, used early data from the study to tell Alsop there was a 70 percent chance he would keep his good sexual function after nerve-sparing surgery. That number was reassuring, Alsop said, and he was convinced surgery was the best choice for him for medical reasons. Now, nine months after treatment, his sexual function is returning, but isn’t yet back to where it was.

“I’m feeling good about where I’m headed,” Alsop said. “Let’s just be frank. It’s an important issue. … My advice to any couple would be to think and act like young lovers, and explore what works for you and what doesn’t,” Alsop said.

The researchers followed the men for two years after treatment.

In the men who were potent before treatment, 52 percent reported problems with erections two years after treatment. That included 60 percent of the men who had their prostates removed, 42 percent who had regular radiation and 37 percent of the men who had radioactive seeds, also called brachytherapy.

Brooks of the American Cancer Society cautioned that sexual problems can show up later for men who have either type of radiation therapy. A two-year follow-up may not have been long enough, he said.

The study was done from 2003 through 2006, a time when laparoscopic surgery, with small incisions and often performed robotically, was less common than it is today.

Dr. Michael Barry of Massachusetts General Hospital in Boston and president of the Foundation for Informed Medical Decision Making said it’s not clear yet whether the newer surgical technique is better or worse for sexual function.

“This paper gives us one piece of the puzzle,” said Barry, who wrote an accompanying editorial. “It doesn’t address what are my chances with problems of incontinence? Or what are my chances of dying of prostate cancer for these different treatments? A patient would want to synthesize all that information to figure out what to do.”

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Online:

JAMA: http://jama.ama-assn.org