Skip to main content

Advertisement

SpringerLink
Log in

Impact of preoperative antiandrogen medication and nerve-sparing surgery on the outcome of radical prostatectomy

  • Urology-Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Objectives

Radical prostatectomy in antiandrogen-medicated patients, as well as nerve-sparing surgery, has increased within recent years. We investigated the impact of antiandrogen medication on loss of blood and of nerve-sparing surgery on continence and potency.

Methods

A total of 401 men who underwent radical prostatectomy between January 1995 and September 1999 at our clinic were asked about antiandrogenic medication prior to radical prostatectomy and about daily life activities, overall satisfaction, voiding ability, and sexual activities. Consumption of erythrocyte concentrates and cryoprecipitated plasma was taken from the records.

Results

The average follow-up was 36 months. Seventy-two percent (n = 289) of our patients replied. Sixty-seven men (23%) who replied to our questionnaire had received antiandrogen medication prior to radical prostatectomy. In 53 (18%) of the men, the nerve-sparing technique was used. In antiandrogen-medicated patients, we observed a significantly elevated consumption of erythrocyte concentrates (antiandrogen-medicated 0.93, not antiandrogen-medicated 0.44; P = 0.013) and of cryoprecipitated plasma (antiandrogen-medicated 0.39, not antiandrogen-medicated 0.08; P = 0.010). Patients who underwent the nerve-sparing technique reported better results in daily life activities, general health status, International Prostate Symptom Score (IPSS), and continence.

Conclusion

Our results point to a higher quality of life in patients who had undergone nerve-sparing surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V. (Association of Population-Based Cancer Registries in Germany) in cooperation with the Robert Koch Institut (2006) Cancer in Germany Incidence and Trends. Fifth revised, updated edition Saarbrücken, pp 68–71.http://www.ekr.med.uni-erlangen.de/GEKID/Doc/kid2006_englisch.pdf. Cited 27 Dec 2007

  2. RKI Robert-Koch-Institut (2004) EUCAN 98. In: Arbeitsgemeinschaft Bevölkerungsbezogener Krebsregister in Deutschland. Krebs in Deutschland Häufigkeiten und Trends 4. überarbeitete, aktualisierte Ausgabe Saarbrücken, pp 64–67

  3. Quinn M, Bapp P (2002) Patterns and trends in prostate cancer incidence, survival, prevalence and mortality. Part I. International comparisons. BJU Int 90:162–173

    Article  PubMed  CAS  Google Scholar 

  4. Noldus J, Graefen M, Haese A et al (2000) Stage migration in clinically localized prostate cancer. Eur Urol 38: 74–78

    Article  PubMed  CAS  Google Scholar 

  5. Reiner WG, Scott WW, Eggleston JC, Walsh PC (1979) Long-term survival after hormonal therapy for stage D prostatic cancer. J Urol 122:183–184

    PubMed  CAS  Google Scholar 

  6. Walsh PC, Donker PJ (1982) Impotence following radical prostatectomy: insight into etiology and prevention. J Urol 128:492–497

    PubMed  CAS  Google Scholar 

  7. Holmberg L, Bill-Axelson A, Helgesen F et al (2002) Scandinavian Prostatic Cancer Group Study number 4: a randomised trial comparing radical prostatectomy with watchful waiting in early prostate cancer. N Engl J Med 347:781–789

    Article  PubMed  Google Scholar 

  8. Hellerstedt BA, Pienta KJ (2002) The current state of hormonal therapy for prostate cancer. CA Cancer J Clin 52:154–179

    Article  PubMed  Google Scholar 

  9. Prezioso D, Lotti T, Polito M, Montironi R (2004) Neoadjuvant hormone treatment with leuprolide acetate depot 3.75 mg and cyproterone acetate, before radical prostatectomy: a randomized study. Urol Int 72:189–195

    Article  PubMed  CAS  Google Scholar 

  10. Wirth M, Tyrrell C, Delaere K et al ‘Casodex’ Early Prostate Cancer Trialists’ Group (2005) Bicalutamide (‘Casodex’) 150 mg in addition to standard care in patients with nonmetastatic prostate cancer: updated results from a randomised double-blind phase III study (median follow-up 5.1 y) in the early prostate cancer programme. Prostate Cancer Prostatic Dis 8:194–200

    Google Scholar 

  11. Jonler M, Madsen FA, Rhodes PR et al (1996) A prospective study of quantification of urinary incontinence and quality of life in patients undergoing radical retropubic prostatectomy. Urology 48:433–440

    Article  PubMed  CAS  Google Scholar 

  12. Jedrusik P, Schulze H, Claussen CD, Golka K (2005) Low-cost data transfer from a questionnaire to standard software using a barcode pen. Behav Res Methods 37:127–132

    PubMed  CAS  Google Scholar 

  13. Litwiller SE, Djavan B, Kolpukh BV et al (1995) Radical retropubic prostatectomy for localised carcinoma of the prostate in a large metropolitan hospital. Changing trends over a 10-year-period (1984–1994). Dallas Outcome Research Group for Urological Diseases. Urology 45:813–822

    Google Scholar 

  14. Epstein JI, Chan DW, Sokoll LJ et al (1998) Nonpalpable stage T1c prostate cancer: prediction of insignificant disease using free/total prostate specific antigen levels and needle biopsy findings. J Urol 160:2407–2411

    Article  PubMed  CAS  Google Scholar 

  15. Noldus J, Graefen M, Hammerer P et al (1998) Entwicklung der Tumorselektion anhand des pathologischen Stadiums beim klinischen lokalisierten Prostatakarzinom. Urologe A 37:195–198

    Article  PubMed  CAS  Google Scholar 

  16. Thompson IM, Middelton RG, Optenberg SA et al (1999) Have complication rates decreased after treatment for localized prostate cancer? J Urol 162:107–112

    Article  PubMed  CAS  Google Scholar 

  17. Lu-Yao GL, Yao SL (1997) Population-based study of long-term survival in patients with clinically localised prostate cancer. Lancet 349:906–910

    Article  PubMed  CAS  Google Scholar 

  18. Fowler FJ Jr, Barry MJ, Lu-Yao G et al (1993) Patient-reported complications and follow-up treatment after radical prostatectomy. The national Medicare Experience: 1988–1990 (updated 1993). Urology 42:622–629

    Google Scholar 

  19. Eastham JA, Kattan UW, Rogers E et al (1996) Risk factors for urinary incontinence after radical prostatectomy. J Urol 156:1707–1713

    Article  PubMed  CAS  Google Scholar 

  20. Walsh PC (2000) Patient-reported urinary continence and sexual function after anatomic radical prostatectomy. J Urol 164:242

    PubMed  CAS  Google Scholar 

  21. Catalona WJ, Basler JW (1993) Return of erections and urinary continence following nerve sparing radical retropubic prostatectomy. J Urol 150:905–907

    PubMed  CAS  Google Scholar 

  22. Geary ES, Dendinger TE, Freiha FS, Stamey TA (1995) Nerve sparing radical prostatectomy: a different view. J Urol 154:145–149

    Article  PubMed  CAS  Google Scholar 

  23. Noldus J, Michl U, Graefen M et al (2001) Die nerverhaltende radikale retropubische Prostatektomie. Urologe A 40:102–106

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Author notes

  1. H.-J. Knopf

    Present address: Department of Urology, St. Ansgar-Hospital, Hoexter, Germany

Authors and Affiliations

  1. Department of Urology, Marien-Hospital Marl, Hervesterstr. 57, 45768, Marl, Germany

    J. Hodzic

  2. Department of Urology, Klinikum Dortmund, Dortmund, Germany

    J. Hodzic, P. Jedrusik, T. Reckwitz & H.-J. Knopf

  3. Institute for Occupational Physiology at the University of Dortmund (IfADo), Dortmund, Germany

    P. Jedrusik & K. Golka

Authors
  1. J. Hodzic
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Jedrusik
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T. Reckwitz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H.-J. Knopf
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. K. Golka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Hodzic.

Additional information

J. Hodzic and P. Jedrusik contributed equally.

Dedicated to the late Harald Schulze, director of the Department of Urology, Klinikum Dortmund.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hodzic, J., Jedrusik, P., Reckwitz, T. et al. Impact of preoperative antiandrogen medication and nerve-sparing surgery on the outcome of radical prostatectomy. Int Urol Nephrol 40, 965–970 (2008). https://doi.org/10.1007/s11255-008-9372-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-008-9372-5

Keywords

Search

Navigation