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Assessment of Return to Baseline Urinary and Sexual Function Following Primary Focal Cryotherapy for Nonmetastatic Prostate Cancer

Lookup NU author(s): Dr Stuart McCracken

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Abstract

© 2019 European Association of Urology. Background: The oncological outcomes in men with clinically significant prostate cancer following focal cryotherapy are promising, although functional outcomes are under-reported. Objective: To determine the impact of focal cryotherapy on urinary and sexual function, specifically assessing return to baseline function. Design, setting, and participants: Between October 2013 and November 2016, 58 of 122 men who underwent focal cryotherapy for predominantly anterior clinically significant localised prostate cancer within a prospective registry returned patient-reported outcome measure questionnaires, which included International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF-15) questionnaires. Intervention: Standard cryotherapy procedure using either the SeedNet or the Visual-ICE cryotherapy system. Outcome measurements and statistical analysis: Primary outcome was return to baseline function of IPSS score and IIEF erectile function (EF) subdomain. Cumulative incidence and Cox-regression analyses were performed. Results and limitations: Probability of returning to baseline IPSS function was 78% at 12 mo and 87% at both 18 and 24 mo, with recovery seen up to 18 mo. For IIEF (EF domain), the probability of returning to baseline function was 85% at 12 mo and 89% at both 18 and 24 mo, with recovery seen up to 18 mo. Only the preoperative IIEF-EF score was associated with a poor outcome (hazard ratio 0.96, 95% confidence interval 0.93–0.999, p = 0.04). The main limitation was that only half of the patients returned their questionnaires. Conclusions: In men undergoing primary focal cryotherapy, there is a high degree of preservation of urinary and erectile function with return to baseline function occurring from 3 mo and continuing up to 18 mo after focal cryotherapy. Patient summary: In men who underwent focal cryotherapy for prostate cancer, approximately nine in 10 returned to their baseline urinary and sexual function. Keeping in mind that level 1 evidence and long-term data are still needed, in men who wish to preserve urinary and sexual function, focal cryotherapy may be considered an alternative treatment option to radical therapy.© 2019 European Association of UrologyIn men undergoing primary focal cryotherapy predominantly for anterior disease, there is high degree of preservation of urinary and erectile function, with return to baseline function of International Prostate Symptom Score in 87% and erectile function in 92% by 18 mo after focal cryotherapy. In men who wish to preserve urinary and sexual function, focal cryotherapy should be considered.

Publication metadata

Author(s): Shah TT, Peters M, Miah S, Eldred-Evans D, Yap T, Hosking-Jervis F, Dudderidge T, Hindley RG, McCracken S, Greene D, Nigam R, Valerio M, Winkler M, Virdi J, Arya M, Ahmed HU, Minhas S

Publication type: Article

Publication status: Published

Journal: European Urology Focus

Year: 2021

Volume: 7

Issue: 2

Pages: 301-308

Print publication date: 01/03/2021

Online publication date: 05/10/2019

Acceptance date: 04/09/2019

ISSN (electronic): 2405-4569

Publisher: Elsevier BV

URL: https://doi.org/10.1016/j.euf.2019.09.004

DOI: 10.1016/j.euf.2019.09.004

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