Impact of Focal Versus Whole Gland Ablation for Prostate Cancer on Sexual Function and Urinary Continence
| Autor: | Sidney Glina, Rafael Castilho Borges, Petr Macek, Rafael Tourinho-Barbosa, Rafael Sanchez-Salas, Xavier Cathelineau, Annick Mombet |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Ablation Techniques
Male medicine.medical_specialty Urology medicine.medical_treatment 030232 urology & nephrology Urinary incontinence Cryotherapy Cryosurgery Severity of Illness Index 03 medical and health sciences Prostate cancer Postoperative Complications 0302 clinical medicine Erectile Dysfunction medicine Humans Aged Urinary continence business.industry Prostate Prostatic Neoplasms Middle Aged Erectile function medicine.disease Ablation Treatment Outcome Urinary Incontinence Erectile dysfunction High-Intensity Focused Ultrasound Ablation medicine.symptom Sexual function business Follow-Up Studies |
| Zdroj: | Journal of Urology. 205:129-136 |
| ISSN: | 1527-3792 0022-5347 |
| Popis: | Focal instead of whole gland ablation for prostate cancer has been proposed to decrease treatment morbidity. We sought to determine differences in erectile function and urinary continence after focal and whole gland ablation for prostate cancer.From 2009 to 2018, 346 patients underwent high intensity focused ultrasound or cryotherapy for prostate cancer. Urinary continence was defined as use of no pads and sexual potency as enough erection for sexual penetration. Logistic regressions to treatment groups and covariates age, prostate specific antigen, International Society of Urological Pathology grading, prostate volume and energy modality were performed to access the effect of focal therapy in sexual potency and urinary continence after 3 and 12 months. IIEF-5 (International Index of Erectile Function) and I-PSS (International Prostate Symptom Score) questionnaires were evaluated. Propensity score matching was performed to adjust for potential baseline differences between groups.After exclusion, 195 post-focal therapy and 105 post-whole gland therapy patients were included in analysis. No significant difference was seen in baseline I-PSS and IIEF-5 scores. In multivariate models focal therapy was the most important factor related to sexual potency at 3 (OR 7.7) and 12 months (OR 3.9). Median IIEF-5 score at 3 months was 12 and 5 (p0.001), and at 12 months was 13 and 9 (p=0.04) in focal therapy and whole gland therapy groups, respectively. Focal therapy was the only factor related to continence (OR 0.7, p0.001). Results remained significant after propensity score matching.Focal ablation instead of whole gland therapy is the most important factor related to better sexual and urinary continence recovery after high intensity focused ultrasound and cryotherapy for prostate cancer. |
| Databáze: | OpenAIRE |
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