Impact of Focal Versus Whole Gland Ablation for Prostate Cancer on Sexual Function and Urinary Continence

No AccessJournal of UrologyAdult Urology1 Jan 2021Impact of Focal Versus Whole Gland Ablation for Prostate Cancer on Sexual Function and Urinary Continence Rafael Castilho Borges, Rafael Rocha Tourinho-Barbosa, Sidney Glina, Petr Macek, Annick Mombet, Rafael Sanchez-Salas, and Xavier Cathelineau Rafael Castilho BorgesRafael Castilho Borges Department of Urology, Institut Mutualiste Montsouris, Paris, France Department of Urology, Faculdade de Medicina do ABC, São Paulo, Brazil More articles by this author , Rafael Rocha Tourinho-BarbosaRafael Rocha Tourinho-Barbosa Department of Urology, Institut Mutualiste Montsouris, Paris, France Department of Urology, Hospital Cardiopulmonar, Salvador, Brazil More articles by this author , Sidney GlinaSidney Glina Department of Urology, Faculdade de Medicina do ABC, São Paulo, Brazil More articles by this author , Petr MacekPetr Macek Department of Urology, Institut Mutualiste Montsouris, Paris, France More articles by this author , Annick MombetAnnick Mombet Department of Urology, Institut Mutualiste Montsouris, Paris, France More articles by this author , Rafael Sanchez-SalasRafael Sanchez-Salas *Correspondence: Department of Urology, Institut Mutualiste Montsouris, 42, Boulevard Jourdan, 75674Paris, France telephone: +33-1-56-61-62-63; E-mail Address: [email protected] Department of Urology, Institut Mutualiste Montsouris, Paris, France More articles by this author , and Xavier CathelineauXavier Cathelineau Department of Urology, Institut Mutualiste Montsouris, Paris, France More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001327AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Focal instead of whole gland ablation for prostate cancer has been proposed to decrease treatment morbidity. We sought to determine differences in erectile function and urinary continence after focal and whole gland ablation for prostate cancer. Materials and Methods: From 2009 to 2018, 346 patients underwent high intensity focused ultrasound or cryotherapy for prostate cancer. Urinary continence was defined as use of no pads and sexual potency as enough erection for sexual penetration. Logistic regressions to treatment groups and covariates age, prostate specific antigen, International Society of Urological Pathology grading, prostate volume and energy modality were performed to access the effect of focal therapy in sexual potency and urinary continence after 3 and 12 months. IIEF-5 (International Index of Erectile Function) and I-PSS (International Prostate Symptom Score) questionnaires were evaluated. Propensity score matching was performed to adjust for potential baseline differences between groups. Results: After exclusion, 195 post-focal therapy and 105 post-whole gland therapy patients were included in analysis. No significant difference was seen in baseline I-PSS and IIEF-5 scores. In multivariate models focal therapy was the most important factor related to sexual potency at 3 (OR 7.7) and 12 months (OR 3.9). Median IIEF-5 score at 3 months was 12 and 5 (p <0.001), and at 12 months was 13 and 9 (p=0.04) in focal therapy and whole gland therapy groups, respectively. Focal therapy was the only factor related to continence (OR 0.7, p <0.001). Results remained significant after propensity score matching. Conclusions: Focal ablation instead of whole gland therapy is the most important factor related to better sexual and urinary continence recovery after high intensity focused ultrasound and cryotherapy for prostate cancer. References 1. : The prostate specific antigen era in the United States is over for prostate cancer: what happened in the last 20 years?J Urol 2004; 172: 1297. 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Google Scholar No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited BySmith J (2020) This Month in Adult UrologyJournal of Urology, VOL. 205, NO. 1, (1-3), Online publication date: 1-Jan-2021. Volume 205Issue 1January 2021Page: 129-136Supplementary Materials Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.Keywordsprostatic neoplasmsurinary incontinenceerectile dysfunctionhigh-intensity focused ultrasound ablationcryotherapyMetricsAuthor Information Rafael Castilho Borges Department of Urology, Institut Mutualiste Montsouris, Paris, France Department of Urology, Faculdade de Medicina do ABC, São Paulo, Brazil More articles by this author Rafael Rocha Tourinho-Barbosa Department of Urology, Institut Mutualiste Montsouris, Paris, France Department of Urology, Hospital Cardiopulmonar, Salvador, Brazil More articles by this author Sidney Glina Department of Urology, Faculdade de Medicina do ABC, São Paulo, Brazil More articles by this author Petr Macek Department of Urology, Institut Mutualiste Montsouris, Paris, France More articles by this author Annick Mombet Department of Urology, Institut Mutualiste Montsouris, Paris, France More articles by this author Rafael Sanchez-Salas Department of Urology, Institut Mutualiste Montsouris, Paris, France *Correspondence: Department of Urology, Institut Mutualiste Montsouris, 42, Boulevard Jourdan, 75674Paris, France telephone: +33-1-56-61-62-63; E-mail Address: [email protected] More articles by this author Xavier Cathelineau Department of Urology, Institut Mutualiste Montsouris, Paris, France More articles by this author Expand All No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. 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