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Abstract

Volume 23, Issue 5 (September 2021) 23, 520–526; 10.4103/aja.aja_3_21

Relationship of preoperative androgen levels and metabolic syndrome with quality of life and erectile function in patients who are to undergo radical prostatectomy

Yann Neuzillet1, Jean-François Dreyfus2, Jean-Pierre Raynaud3, Mathieu Rouanne1, Marc Schneider4, Morgan Roupret5, Sarah Drouin5, Marc Galiano6, Xavier Cathelineau6, Thierry Lebret1, Henry Botto1

1 Department of Urology, Hôpital Foch, UVSQ-Paris-Saclay University, Suresnes 92150, France
2 Department of Clinical Research and Innovation, Hôpital Foch, UVSQ-Paris-Saclay University, Suresnes 92150, France
3 Sorbonne University, Paris 75013, France
4 Department of Urology, Hôpital Louis Pasteur, Colmar 68000, France
5 Department of Urology, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Paris 75013, France
6 Department of Urology, Institut Mutualiste Montsouris, Paris-Descartes University, Paris 75014, France

Correspondence: Dr. Y Neuzillet (y.neuzillet@hopital-foch.com)

Date of Submission 24-Jul-2020 Date of Acceptance 28-Dec-2020 Date of Web Publication 05-Mar-2021

Abstract

This study aims to investigate whether clinical and biological preoperative characteristics of patients who were to undergo radical prostatectomy were associated with impairment in patient-reported quality of life (QoL) and erectile dysfunction immediately before intervention. We evaluated patient-reported outcomes among 1019 patients (out of 1343) of the AndroCan study, willing to score the Aging Male Symptom (AMS) and the International Index of Erectile Function 5-item (IIEF-5) auto-questionnaires. Univariate linear regression and robust multiple regression were used to ascertain the relationship between demographic, clinical, and hormonal parameters and global AMS or IIEF-5 scores. As a result, most patients (85.1') of the Androcan cohort agreed to complete questionnaires. Significantly higher IIEF-5 global scores were found in non-Caucasian and obese patients, with larger waist circumference, metabolic syndrome, diabetes mellitus, cardiovascular disease, hypertension, high blood sugar, concomitant medications, and hypogonadism, while the AMS global score was significantly higher in patients with larger waist circumference, metabolic syndrome, high blood pressure, raised glycemia, and concomitant medication. The IIEF-5 global score was correlated to age, dehydroepiandrosterone (DHEA), fat mass percentage, and androstenediol (D5). The AMS global score was significantly correlated to DHEA, D5, and DHEA sulfate. Finally, the multivariate models showed that QoL and erectile function were significantly affected, before surgery, by symptoms and signs that are usually considered as pertaining to the metabolic syndrome, while sexual hormones are essentially correlated to erectile dysfunction.

Keywords: erectile function; metabolic syndrome; quality of life; radical prostatectomy; testosterone

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Asian Journal of Andrology CN 31-1795/R ISSN 1008-682X  Copyright © 2023  Shanghai Materia Medica, Chinese Academy of Sciences.  All rights reserved.