Satisfaction and genital perception after orchiectomy for prostate cancer: does the technique matter? A randomized trial
| Autor: | Arun Jacob Philip George, Nitin S Kekre, Partho Mukherjee, Onkar Singh, Antony Devasia, Santosh Kumar, Cornerstone Wann, Rajesh Gopalakrishnan, Belavendra Antonisamy, J Chandrasingh, M S Sakthivel |
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| Rok vydání: | 2020 |
| Předmět: |
Nephrology
Male medicine.medical_specialty genetic structures Urology 030232 urology & nephrology 030204 cardiovascular system & hematology law.invention Androgen deprivation therapy Perceptual Disorders 03 medical and health sciences Prostate cancer 0302 clinical medicine Postoperative Complications Randomized controlled trial Quality of life law Internal medicine Scrotum medicine Humans Sex organ Orchiectomy Prospective Studies business.industry Prostatic Neoplasms medicine.disease Surgery medicine.anatomical_structure Patient Satisfaction Self Report business |
| Zdroj: | International urology and nephrology. 53(8) |
| ISSN: | 1573-2584 |
| Popis: | Bilateral extracapsular or total orchiectomy (BEO) for prostate cancer is presumed to have psychological consequences after the surgery due to perception of an empty scrotum. Bilateral subcapsular orchiectomy (BSO) was designed to preserve perception of palpable testes. We compared the patients' satisfaction and genital perception following BEO and BSO. Prostate cancer patients eligible for androgen deprivation therapy who opted for orchiectomy were enrolled in prospective randomized study. Patients with bleeding disorder or uncorrected coagulopathy, poor performance score, and psychiatric problems were excluded. Outlook to life and own health in-general, overall satisfaction to the procedure and genital perception was evaluated using modified Fugl-Meyer questionnaire (FMQ) which was administered before and after 3 months of the surgery. Patients were randomized to BEO and BSO groups at the time of surgery using block randomization. Primary outcome was to compare the genital perception of testicular loss and patients’ satisfaction to BSO and BEO. Secondary outcomes included testosterone and PSA control, operative time, and complications. Total 35 patients were enrolled in each group which was comparable. There was no difference in PSA control at 3 months. Mean operative time and blood loss were significantly lesser in BEO group. FMQ score at 3 months did not show significant difference. Majority of the patients in both groups were satisfied with procedure and the aesthetic value of scrotum after surgery. However, 84% in BSO group did not feel that testes were removed on self-examination, as compared to 28% in BEO group. Majority patients in both groups did not report physical or psychological discomfort from change in scrotal content. Results showed that patients’ satisfaction and genital perception following BSO and BEO were similar. Feeling of remaining intrascrotal contents after BSO did not had added psychological advantage in terms of perception of genitalia. |
| Databáze: | OpenAIRE |
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