MP45-15 A PROSPECTIVE ANALYSIS OF THE EFFECTS OF FOCAL THERAPY FOR PROSTATE CANCER ON ERECTILE FUNCTION FROM A COMBINED ANALYSIS OF 3 PROSPECTIVE TRIALS

Field: Medicine (Health Sciences)

You have accessJournal of UrologyProstate Cancer: Localized III1 Apr 2014MP45-15 A PROSPECTIVE ANALYSIS OF THE EFFECTS OF FOCAL THERAPY FOR PROSTATE CANCER ON ERECTILE FUNCTION FROM A COMBINED ANALYSIS OF 3 PROSPECTIVE TRIALS Tet Yap, Hashim Ahmed, Richard Hindley, Neil McCartan, Susan Charman, Stephanie Guillaumier, Louise Dickinson, Mark Emberton, and Suks Minhas Tet YapTet Yap More articles by this author , Hashim AhmedHashim Ahmed More articles by this author , Richard HindleyRichard Hindley More articles by this author , Neil McCartanNeil McCartan More articles by this author , Susan CharmanSusan Charman More articles by this author , Stephanie GuillaumierStephanie Guillaumier More articles by this author , Louise DickinsonLouise Dickinson More articles by this author , Mark EmbertonMark Emberton More articles by this author , and Suks MinhasSuks Minhas More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1212AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives One of the major factors affecting patient decision-making when diagnosed with localized prostate cancer, is the effect of potential interventions on erectile function. Focal therapy is a treatment option in localized prostate cancer that can potentially reduce the burden of erectile dysfunction. In this analysis, we evaluate both subjective (IIEF score) and objective (PDE5 inhibitor use) parameters of erectile function using the combined data of 3 prospective IRB-approved trials. Methods 116 men with prostate cancer (PSA≤15ng/mL, Gleason≤4+3, stage≤T3aN0M0) treated with focal high intensity focused ultrasound (HIFU) were included. HIFU was delivered to cancer lesions, with a margin of normal tissue, identified on multi-parametric MRI and template prostate-mapping biopsies. IIEF-ED scores and use of PDE5-inhibitors were collected preoperatively and at one, 3, 6 9 and 12 months postoperatively. Paired t-tests were used to compare scores between time-points or groups as appropriate. Results Median age was 63 years (range 49 to 76yrs). Mean IIEF-erectile score at baseline was 19.8 (95%CI 18.1 to 21.5). This declined significantly to 12.5 (95% CI 10.7 to 14.3, p <0.01) at one month, improving to 15.7 (95% CI 13.8 to 17.6, p=0.007) at 3 months, 17.5 (95% CI 15.7 to 19.3, p=0.054) at 6 months and 18.2 (95% CI 16.4 to 20.0, p=0.30) at 12 months post-treatment. Changes in total IIEF and other IIEF domains were only significantly different from pre-operative values at one and 3 months postoperatively. In the same period, the proportion of men using PDE5-inhibitors were 9% pre-operatively, 12% at 1 month, 29% at 3 months, reaching 42% at 6 & 9 months before dropping to 35% at a year. In patients started on PDE5-inhibitors post-operatively, there was a significant improvement in IIEF â€“ erectile score (5.8, 95% CI 2.0 to 9.5, p<0.01) and total IIEF (13.3, 95% CI 5.0 to 21.6, p<0.01) compared to those not on PDE5-inhibitors. The change in IIEF scores between those who came off PDE5-inhibitors at 12 months was not significant compared to those that remained on medication. Conclusions Erectile function improves after focal HIFU following an early postoperative decline such that at 6 months, there is no significant difference in IIEF total, erectile & domain scores compared to baseline. 65% of patients maintain potency without PDE-5 inhibitors. IIEF scores did not vary significantly between those who continued and those who stopped PDE5 inhibitors at 12 months and may reflect recovery of erectile function (as mean IIEF scores rise to near baseline levels). © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e465 Advertisement Copyright & Permissions© 2014Metrics Author Information Tet Yap More articles by this author Hashim Ahmed More articles by this author Richard Hindley More articles by this author Neil McCartan More articles by this author Susan Charman More articles by this author Stephanie Guillaumier More articles by this author Louise Dickinson More articles by this author Mark Emberton More articles by this author Suks Minhas More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...