(544) Minimally Invasive, Maximally Preserved: Sexual Function After Focal Brachytherapy for Pros-Tate Cancer – Insights from the CapFIRE Trial

Abstract Introduction Erectile dysfunction (ED) and disturbances in ejaculo-orgasmic function are common conse-quences following prostate cancer whole-gland treatments. Focal therapy offers a minimally invasive alternative for selected patients with localized tumors, aiming to ablate the tumor, while preserving nearby healthy prostatic tissue and neurovascular structures essential for maintaining sexual function. Objective To assess sexual function outcomes following focal brachytherapy in men with unilateral prostate cancer. Methods Forty men underwent curative intended targeted focal brachytherapy of prostate cancer as part of a prospective institutional approved clinical trial between January 2024 and May 2025. All included men provided written informed consent. Validated questionnaires (International Index of erectile Function IIEF-5, Erection Hardness Score EHS) and previously applied, purpose-designed questions ad-dressing ejaculatory and orgasmic function were administered at baseline and predefined follow-up intervals. Additional data included age, patient-reported changes in potency and satisfaction, and use of phosphodiesterase-5 (PDE-5) inhibitors. This report presents findings from 6-months follow-up. Results Median age was 63 years (range 50–71); 88% (35/40) completed 6-month follow-up. No pa-tients initiated new PDE-5 inhibitor therapy post-treatment. Mean IIEF-5 score declined slight-ly from 20.4 to 19.6 (p=0.510). At baseline, 82% had IIEF-5 ≥17 (mild/no erectile dysfunction); 68% retained this status at 6 months (p=0.291). Mean EHS decreased from 3.3 to 3.1 (p=0.276), and erections sufficient for intercourse (EHS ≥3) were maintained in 82% at 6 months, compared to 90% at baseline (p=0.718). Patient-reported satisfaction with current potency remained high (77% vs. 82% at baseline; p=0.835) with 77% reporting unchanged erectile function. Ejaculo-orgasmic function was maintained in most patients; 79% reported ejaculation always/often (vs. 90% pre-treatment; p=0.325), and 82% reported orgasm al-ways/often (vs. 87%; p=0.529). Orgasmic intensity was unchanged in 65%, reduced in 29%, increased in one patient, and absent in another patient. Painful orgasms were rare, with only 9% experiencing them occasionally; No cases of orgasm-associated incontinence were re-ported. The sexual function scores remained stable across follow-up timepoints (1-, 3-, and 6-months). Conclusions Preliminary findings suggest that men undergoing focal brachytherapy can preserve both erectile and ejaculo-orgasmic function with satisfactory outcomes at 6 months post-treatment, supporting its potential as a minimally invasive, function-preserving treatment option for se-lected patients with localized prostate cancer. Disclosure No