Satisfaction and genital perception after orchiectomy for prostate cancer: does the technique matter? A randomized trial

Singh, Onkar; Mukherjee, Partho; Sakthivel, M S; Wann, Cornerstone; George, M. Anne; Gopalakrishnan, Rajesh; Antonisamy, Belavendra; Devasia, Antony; Kumar, Santosh; Kekre, Nitin S; Chandrasingh, J

doi:10.1007/s11255-021-02849-z

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…compared the efficacy of BTO and BSO and concluded an adequate castration level, however, the patients’ emotional satisfaction was better in BSO group than BTO group ( 12 ). There were also studies suggesting that BSO showed no psychological benefit compared to BTO ( 18 , 19 ). Issa et al.…”

Section: Discussionmentioning

confidence: 99%

“…The study by Selvi et al compared the efficacy of BTO and BSO and concluded an adequate castration level, however, the patients' emotional satisfaction was better in BSO group than BTO group (12). There were also studies suggesting that BSO showed no psychological benefit compared to BTO (18,19). Issa et al reported the epididymal sparing bilateral simple orchiectomy as an alternative surgical approach which aimed at maintaining the esthetic appearance of the scrotum and improving patient satisfaction (20).…”

Section: Surgical Castrationmentioning

confidence: 99%

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Luteinizing hormone-releasing hormone agonists versus orchiectomy in the treatment of prostate cancer: A systematic review

Zhang

Zhang²,

Wang³

et al. 2023

Front. Endocrinol.

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BackgroundOrchiectomy has been replaced by medication represented by luteinizing hormone-releasing hormone (LHRH) agonist as the first-line therapy for androgen deprivation therapy (ADT). After the wide application of LHRH agonist, the side-effects of long-term ADT were noticed. It is time to reconsider the role of medication and surgeries in the treatment of prostate cancer.MethodsEmbase, Pubmed, Web of science and Cochrane library were searched for relevant trials. Quality of the studies and risk of bias were assessed by using the Newcastle-Ottawa Scale (NOS). Therapeutic and adverse effects, as well as long-term metabolic adverse effects were extracted from the selected studies. The data synthesized in meta-analyses were performed with R software (4.2.1). Risk ratio (RR) with its 95% confidence interval (CI) was calculated by combining outcome data including complete and partial response rate, progression rate, death rate and adverse effects such as hot flash and increase in pain. Descriptive analysis was performed among the prostate specific antigen (PSA), testosterone and metabolic adverse effects due to a lack of homogeneity of frailty measures.Results1,711 participants from 11 studies were included in our systematic review. 1,258 patients from six studies were included in the meta-analysis. Based on the meta-analysis, the therapeutic and adverse outcomes included overall response rate, complete response rate, partial response rate, stable rate, progression rate, death rate and hot flashes. No statistical significance was observed between LHRH agonists and orchiectomy. Compared with surgery, LHRH agonist elevated the risk of the increase in pain. In descriptive analysis, it was shown that the therapeutic effects between PSA and testosterone also showed no significant difference. Both groups had lipid and glucose metabolic disorders, and a few studies reported worse lipid metabolic performance in orchiectomy group and worse insulin resistance in LHRH agonist group.ConclusionWe found that the therapeutic outcomes were similar between the two options. The results of lipid and glucose metabolic abnormality were controversial in existing studies. The direct comparison studies on metabolic adverse effects should be performed in the future. The therapeutic, metabolic, psychological and economical effects should be considered before applying ADT methods.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022365891.

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Section: Discussionmentioning

confidence: 99%

Section: Surgical Castrationmentioning

confidence: 99%

Luteinizing hormone-releasing hormone agonists versus orchiectomy in the treatment of prostate cancer: A systematic review

Zhang

Zhang²,

Wang³

et al. 2023

Front. Endocrinol.

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Androgendeprivationstherapie beim metastasierten Prostatakarzinom

Hammerer,

Manka

2023

Metastasiertes Prostatakarzinom

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Cosmetic Appeal, HRQoL, and Effectiveness of Simple and Pseudotesticular Techniques of Orchidectomy in Prostate Cancer

et al. 2021

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Introduction. Orchidectomy is the most cost-effective means of hormonal therapy for locally advanced or metastatic prostate cancer (LAMP). However, cost-effectiveness should not detract from health-related quality of life (HRQoL) considerations. Bilateral simple orchidectomy (BSO) has been linked to negative psychometric deficits from an empty scrotum. This study compared the HRQoL, therapeutic efficacy, and cosmetic appeal of BSO with endogenous pseudotesticular techniques of bilateral subcapsular orchidectomy (BSCO) and bilateral-epididymal-sparing orchidectomy (BESO). Research Design. Nigerian patients with LAMP were randomised into three surgical arms: BSO, BSCO, and BESO. Expanded Prostate Cancer Index Composite-26 HRQoL and sociodemographic questionnaires were administered before and three months after orchidectomy. Serum testosterone and PSA were measured at 0, 1, 2, and 3 hours; 7 days; and 3 months postoperatively. Pseudotesticular volumes and cosmetic appeal were assessed at 3 months. Result. Sixty-three patients were recruited (24 BSO, 21 BSCO, 18 BESO), 73% of whom were low-income earners. There was no significant difference in the procedure cost nor the PSA or testosterone nadirs achieved over the three-month follow-up period (11.3, 12.6, 15.2 ng/ml ( p = 0.667 ) and 0.44, 0.64, 0.79 nmol/l ( p = 0.603 ) respectively). Those with pseudotesticles (BSCO, BESO) felt less emasculated ( p = 0.010 ). BSCO produced the least sexual bother, highest sexual function, and largest pseudotesticular volumes. The cosmetic appeal scores were similar between groups (77.9 ± 22.8, 81 ± 13.9, and 81.9 ± 22.5, respectively, p = 0.858 ). Conclusion. Endogenous pseudotesticular techniques, when compared with BSO, reduce the negative psychological impact experienced by patients without increasing costs. BSCO produced the best pseudotesticular volumes and postoperative sexual function. This study is registered with the ClinicalTrials.gov of the National Institute of Health U.S. National Library of Medicine as TEPSO study, NCT03744494: Comparison of the Therapeutic Efficacy and Patient Satisfaction of Three Techniques of Bilateral Orchidectomy in Prostate Cancer Patients of a Nigerian Sub-population. Registration completed on 16th of November, 2018 (registered retrospectively) NCT03744494.

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Satisfaction and genital perception after orchiectomy for prostate cancer: does the technique matter? A randomized trial

Cited by 3 publications

References 20 publications

Luteinizing hormone-releasing hormone agonists versus orchiectomy in the treatment of prostate cancer: A systematic review

Luteinizing hormone-releasing hormone agonists versus orchiectomy in the treatment of prostate cancer: A systematic review

Androgendeprivationstherapie beim metastasierten Prostatakarzinom

Cosmetic Appeal, HRQoL, and Effectiveness of Simple and Pseudotesticular Techniques of Orchidectomy in Prostate Cancer

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