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

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.

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

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.