[The treatments of localized prostate cancer: the impact on sexuality]

Nowadays, taking into account the sexuality is an essential component of the management of prostate cancer patients. This implies the necessity for providing accurate, clear and transparent information about the potential adverse effects on the sexual functioning for each proposed treatment. This information is not only given to the patient, but also to his female partner. The association of extended radical prostatectomy (without preservation of neurovascular bundles) and androgen suppression therapy will be proposed for men with locally advanced prostate cancer at high-risk for recurrence. The impact of such combined management regarding sexual functioning is high in terms of erection and sexual interest. Early pharmacological treatment of erectile dysfunction (within the three months following surgical treatment) with phosphodiesterase 5 inhibitors or intracavernous injections will allow an optimal recovery of a certain quality of erection. Moreover, monotherapy with bicalutamide will be associated with significant advantage in terms of sexual interest. The sexuality after treatment will certainly be different but will be accomplished.