The association between low preoperative serum testosterone and post-radical prostatectomy urinary function Journal Article

   

Authors:	Paula Domino, M.; Vertosick, E. A.; Vickers, A. J.; Eastham, J. A.; Sandhu, J. S.
Article Title:	The association between low preoperative serum testosterone and post-radical prostatectomy urinary function
Abstract:	Objective: To determine if hypogonadism leads to delayed urinary function recovery post-radical prostatectomy (RP) by studying the effect of preoperative factors including age, membranous urethral length, radiation therapy, and Body Mass Index on urinary continence in patients with or without hypogonadism. Materials and Methods: We identified 1209 patients treated by RP with both pretreatment T and post-treatment urinary outcome. We assessed whether there was an association between low preoperative T level (prenoon T ≤ 300 ng/dL) and continence (using ≤1 pad/d) at 6 and 12 months post-RP. Patient-reported continence was used when available, otherwise, surgeon-assessed continence was used. Logistic regression models were used, adjusted for age at RP and nerve-sparing status. Results: Median age at RP was 61 (Intraquatile Range (IQR) 56, 66), 92% of patients had at least one nerve spared and 99% were continent at baseline. Continence in patients with low T was nonsignificantly lower at 6 months (odds ratio 0.69, 95% confidence interval 0.44, 1.06; P = .10) and nonsignificantly higher at 12 months (odds ratio 1.07, 95% confidence interval 0.71, 1.58; P = .8). Sensitivity analyses excluding patients with preoperative metastasis or treated with androgen deprivation therapy (ADT) and including testosterone as a continuous predictor were consistent with the primary analysis; similarly finding no evidence of an association. Conclusion: Although we cannot rule out an effect on early continence, overall the evidence does not suggest that low serum testosterone adversely impacts urinary function recovery after RP. This finding can be used to counsel patients enrolled in neoadjuvant ADT trials or those patients undergoing RP who have had prior ADT, such as in the setting of oligometastatic disease. © 2023
Keywords:	adult; controlled study; middle aged; recovery of function; major clinical study; preoperative evaluation; sensitivity analysis; metastasis; radiotherapy; cohort analysis; odds ratio; retrospective study; prediction; age; prostate cancer; confidence interval; prostatic neoplasms; body mass; urine incontinence; prostatectomy; prostate tumor; surgeon; androgen antagonists; radical prostatectomy; antiandrogen; testosterone blood level; hypogonadism; logistic regression analysis; convalescence; androgen deprivation therapy; urinary incontinence; testosterone; continence; urethra; urethral length; urinary tract function; humans; human; male; article; patient history of surgery
Journal Title:	Urology
Volume:	180
ISSN:	0090-4295
Publisher:	Elsevier Science, Inc.
Date Published:	2023-10-01
Start Page:	190
End Page:	193
Language:	English
DOI:	10.1016/j.urology.2023.07.016
PUBMED:	37516254
PROVIDER:	scopus
PMCID:	PMC11457297
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85169565078&doi=10.1016%2fj.urology.2023.07.016&partnerID=40&md5=0a2afedcb547817b8e6b55e572059a2c
Notes:	Article -- MSK corresponding author is Jaspreet Sandhu -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/210704