MP78-03 ASSOCIATION BETWEEN NUMBER OF PROSTATE BIOPSIES AND PATIENT-REPORTED FUNCTIONAL OUTCOMES AFTER RADICAL PROSTATECTOMY: IMPLICATIONS FOR ACTIVE SURVEILLANCE PROTOCOLS (2015)

You have accessJournal of UrologyProstate Cancer: Localized VIII1 Apr 2015MP78-03 ASSOCIATION BETWEEN NUMBER OF PROSTATE BIOPSIES AND PATIENT-REPORTED FUNCTIONAL OUTCOMES AFTER RADICAL PROSTATECTOMY: IMPLICATIONS FOR ACTIVE SURVEILLANCE PROTOCOLS Christopher Anderson, Amy Tin, Daniel Sjoberg, John Mulhall, Jaspreet Sandhu, Karim Touijer, Vincent Laudone, James Eastham, Peter Scardino, and Behfar Ehdaie Christopher AndersonChristopher Anderson More articles by this author , Amy TinAmy Tin More articles by this author , Daniel SjobergDaniel Sjoberg More articles by this author , John MulhallJohn Mulhall More articles by this author , Jaspreet SandhuJaspreet Sandhu More articles by this author , Karim TouijerKarim Touijer More articles by this author , Vincent LaudoneVincent Laudone More articles by this author , James EasthamJames Eastham More articles by this author , Peter ScardinoPeter Scardino More articles by this author , and Behfar EhdaieBehfar Ehdaie More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2819AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Men with prostate cancer who progress on active surveillance (AS) have multiple prostate biopsies prior to radical prostatectomy (RP). We hypothesized that men with more preoperative biopsies had worse urinary function (UF) and erectile function (EF) at 12 months postoperatively. METHODS We identified men treated with RP at our institution from 2008-2011 and excluded those with preoperative incontinence or erectile dysfunction. Patients completed questionnaires at 6 and 12 months postoperatively assessing EF and UF. Primary outcomes were recovery of postoperative UF at 6 and 12 months and EF at 12 months. We defined recovery of EF as an International Index of Erectile Function (IIEF-6) score of ≥22 and recovery of UF as a urinary domain score of ≥17. Number of biopsies was categorized as 1, 2 and ≥ 3. We used multivariable logistic regression to estimate the impact of number of biopsies on functional outcomes. We also fit linear regression models with IIEF-6 score at 12 months and urinary domain score at 6 and 12 months included as continuous variables. RESULTS We identified 2,712 men treated with RP. Most men (80%) had 1 preoperative biopsy, 16% had 2, and 4% had ≥3. On adjusted analysis, EF recovery at 12 months was not significantly different for men with 2 (OR 1.25; 95% CI 0.90, 1.75; p=0.2) or ≥3 (OR 1.52; 95% CI 0.84, 2.78; p=0.2) biopsies compared to those with 1. Similarly, UF recovery at 12 months was not significantly different for men with 2 (0.84, 95% CI 0.64, 1.10; p=0.2) or ≥3 (0.99, 95% CI 0.60, 1.61; p=0.9) biopsies compared to those with 1. Using multivariable linear regression, we did not observe a difference in IIEF-6 score at 12 months according to number of preoperative biopsies. However, men with 2 biopsies had significantly lower UF scores at 6 (β = −0.69; 95% CI −1.30 to −0.07; p = 0.028) and 12 months (β = −0.79; 95% CI −1.36 to −0.22; p = 0.007) compared to men with 1 biopsy. These UF differences were not significant after excluding a small number of outlying observations. CONCLUSIONS In a large RP cohort, we did not observe an association between the number of prostate biopsies and functional outcomes at 12 months postoperatively. Although there were statistically significant differences in UF when analyzed as a continuous variable, these were unlikely to be clinically meaningful. Based on these results, men counseled for AS can be told there is no evidence that repeated biopsy during surveillance increases their risk of urinary or erectile dysfunction if they require delayed RP. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1003 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christopher Anderson More articles by this author Amy Tin More articles by this author Daniel Sjoberg More articles by this author John Mulhall More articles by this author Jaspreet Sandhu More articles by this author Karim Touijer More articles by this author Vincent Laudone More articles by this author James Eastham More articles by this author Peter Scardino More articles by this author Behfar Ehdaie More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...