RESULTS. The probability of maintaining erectile functioning after radiotherapy is 0.69. The probability after surgery is 0.42. This difference is significant. Analysis of 3 Academic Computing Services, The University the effects of variables such as patient age and stage of disease on erectile functionof Calgary, Calgary, Alberta, Canada.ing could not be performed due to inconsistencies across studies and the limited number of studies reporting such variables. CONCLUSIONS.The published data indicate that men with normal erectile functioning are more likely to retain this function after radiotherapy than after surgery. Attention is drawn to the weaknesses in the reviewed studies in the hope that the clinical trials of emerging treatments, such as cryotherapy, brachytherapy, threedimensional conformal radiotherapy, and neoadjuvant hormones can be strengthened to reflect more accurately the rate of treatment-associated erectile dysfunction. Cancer 1997; 79:538-44. ᭧ 1997 American Cancer Society.KEYWORDS: prostatic neoplasms, prostatectomy, radiotherapy, penile erection, impotence. Increasingly larger numbers of men are being faced with the diagnosis of prostate carcinoma. It is estimated that 244,000 men a year receive this diagnosis in the U.S.1 With greater public demand for screening, this trend is unlikely to change.When a man receives a diagnosis of early stage prostate carcinoma, he has a choice of two treatments: radical prostatectomy or radical radiotherapy. Both are believed to be equally effective in curing this carcinoma.2,3 Health professionals and patients often look to published data on the complication rates of these treatments for guidance in choosing between treatments.Recently, the published data on complication rates have been used to calculate the trade-off between the potential negative impact of treatment. The suggestion is made that no treatment may, in fact, be the best choice for some men. 4 Hence, there is a need for accurate Received June 4, 1996, revision received October 7, 1996 accepted October 7, 1996. estimates of complication rates associated with treatments for pros-

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