Androgen deprivation therapy before radical prostatectomy is associated with poorer postoperative erectile function outcomes Journal Article

  

Authors:	Mazzola, C. R.; Deveci, S.; Heck, M.; Mulhall, J. P.
Article Title:	Androgen deprivation therapy before radical prostatectomy is associated with poorer postoperative erectile function outcomes
Abstract:	OBJECTIVE: • To define the impact of androgen deprivation therapy (ADT), undergone before radical prostatectomy (RP), on erectile function (EF) recovery. MATERIAL AND METHODS • A total of 38 consecutive patients presenting to a sexual medicine clinic after undergoing RP who had received ADT before RP (ADT+ group) were compared with a contemporary, age and comorbidity-matched cohort of 94 patients who did not receive ADT (ADT- group) before undergoing RP. • Medical records were reviewed for demographics, comorbidity profiles and duration of ADT exposure. • All the patients underwent Doppler penile ultrasonography within 6 months of RP and were administered the International Index of Erectile Function (IIEF) questionnaire. • All the patients underwent evaluation of EF recovery. We analysed the incidence of venous leak (VL), mean IIEF EF domain score and proportion of men with EF domain scores ≥24 at 18 months after RP. RESULTS: • The mean age, comorbidity profiles, median Gleason score, median pretreatment PSA level, and mean time to evaluation after RP were similar between the two groups. • The median duration of ADT exposure in the ADT+ group was 3 months. • The incidence of VL within 6 months of surgery was 60% for the ADT+ and 20% for the ADT- group ( P < 0.001). Likewise, the IIEF EF domain scores and proportion of men with EF domain scores ≥ 24 at 18 months were significantly lower in the ADT+ group, even when controlled for nerve-sparing status. CONCLUSION: • Our data suggest that preoperative use of ADT adversely impacts EF outcomes and should therefore be avoided in the absence of robust data suggesting any oncological benefit. © 2011 BJU International.
Keywords:	clinical article; controlled study; aged; middle aged; androgen; postoperative period; treatment duration; preoperative care; combined modality therapy; outcome assessment; incidence; doppler echography; medical record review; prostate cancer; gleason score; prostatic neoplasms; preoperative period; prostatectomy; clinical evaluation; comorbidity; androgen antagonists; castration; antineoplastic agents, hormonal; erectile dysfunction; androgen deprivation therapy; leuprolide; penile rehabilitation; erectile function; anastomosis leakage; international index of erectile function; comparative effectiveness; phosphodiesterase 5 inhibitors; hormonotherapy
Journal Title:	BJU International
Volume:	110
Issue:	1
ISSN:	1464-4096
Publisher:	Wiley Blackwell
Date Published:	2012-07-01
Start Page:	112
End Page:	116
Language:	English
DOI:	10.1111/j.1464-410X.2011.10728.10731.x
PROVIDER:	scopus
PUBMED:	22093870
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84862279674&partnerID=40&md5=69e77fbd047f6902dd40047fe9a56d22
Notes:	--- - "Export Date: 2 July 2012" - "CODEN: BJINF" - "Source: Scopus"

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