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Online First

10.4103/aja.aja_88_20

Metabolic syndrome, levels of androgens, and changes of erectile dysfunction and quality of life impairment 1 year after radical prostatectomy

Yann Neuzillet1, Mathieu Rouanne1, Jean-François Dreyfus2, Jean-Pierre Raynaud3, Marc Schneider4, Morgan Roupret5, Sarah Drouin5, Marc Galiano6, Xavier Cathelinau6, Thierry Lebret1, Henry Botto1

1 Department of Urology, Hospital Foch, UVSQ-Paris-Saclay University, Suresnes 92150, France
2 Department of Clinical Research and Innovation, Hospital Foch, UVSQ-Paris-Saclay University, Suresnes 92150, France
3 Sorbonne University, Paris 75013, France
4 Department of Urology, Hospital 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, Montsouris Institute, Paris-Descartes University, Paris 75014, France

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

09-Feb-2021

Abstract

Robust data evaluating the association of preoperative parameters of the patients with quality of life after radical prostatectomy are lacking. We investigated whether clinical and biological preoperative characteristics of the patients were associated with impaired patient-reported quality of life (QoL) and sexual outcomes 1 year after radical prostatectomy. We evaluated patient-reported outcomes among the 1343 men participating in the AndroCan trial (NCT02235142). QoL and erectile dysfunction (ED) were assessed before and 1 year after radical prostatectomy using validated self-assessment questionnaires (Aging Male's Symptoms [AMS] and the 5-item abridged version of the International Index of Erectile Function [IIEF5]). At baseline, 1194 patients (88.9%) accepted to participate. A total of 750 (55.8%) patients answered the 1-year postoperative questionnaires. Out of them, only 378 (50.4% of responders) provided answers that could be used for calculations. One year after prostatectomy, ED had worsened by 8.0 (95% confidence interval [CI]: 7.3–8.7; P < 0.0001) out of a maximum of 20. The global AMS score has worsened by 2.8 (95% CI: 1.7–3.8; P < 0.0001). ED scores 1 year postsurgery were positively correlated with preoperative age and percentage of fat mass, and negatively correlated with total cholesterol, dehydroepiandrosterone (DHEA), and androstenediol (D5); AMS were poorly correlated with preoperative parameters. QoL and sexual symptoms significantly worsened after radical prostatectomy. Baseline bioavailable testosterone levels were significantly correlated with smaller changes on AMS somatic subscores postprostatectomy. These findings may be used to inform patients with newly diagnosed prostate cancer.

Keywords: metabolic syndrome; quality of life; radical prostatectomy; sexual outcomes; testosterone deficiency

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