MP46-19 DETAILING SEXUAL OUTCOMES AFTER FOCAL THERAPY FOR LOCALISED PROSTATE CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy (MP46)1 Sep 2021MP46-19 DETAILING SEXUAL OUTCOMES AFTER FOCAL THERAPY FOR LOCALISED PROSTATE CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS Gaelle Fiard, Aminah Chowdhury, Aneirin Potter, Celina Pook, Daniel Kelly, Mark Emberton, and Tet Yap Gaelle FiardGaelle Fiard More articles by this author , Aminah ChowdhuryAminah Chowdhury More articles by this author , Aneirin PotterAneirin Potter More articles by this author , Celina PookCelina Pook More articles by this author , Daniel KellyDaniel Kelly More articles by this author , Mark EmbertonMark Emberton More articles by this author , and Tet YapTet Yap More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002067.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Focal therapy has emerged as a promising option to treat well-selected men with localised prostate cancer while preserving healthy prostate tissue and key structures, such as the urethral sphincter and neurovascular bundles. However, how this tissue preservation may translate into improved outcomes, particularly into improved sexual outcomes, is still an active research field. We conducted a systematic review and meta-analysis of the literature to summarise the existing evidence in order to provide patients with updated data on what to expect after treatment, and help identify gaps in current knowledge that may warrant future research. METHODS: A systematic literature search was conducted on Medline, EMBASE, Scopus and Web of Science. The search strategy was defined using the ‘litsearchr’ function in R based on a preliminary “naïve” search using the following terms on Medline: ((“focal therapy” OR “focal treatment”) AND (“prostate cancer”) AND (“sexual function” OR “erectile function”)). A total of 37 studies, comprising 2573 patients treated and 1992 with available sexual outcomes were included in the data synthesis. RESULTS: HIFU (n=856, 43%) and cryotherapy (n=404, 20%) accounted for the highest number of patients analysed, while irreversible electroporation (n=137, 7%) was the least studied technique. The 5 item International Index of Erectile Function (IIEF-5) was the most frequently used questionnaire (26/37 studies), with completion rates ranging from 24-100% at 18-24 months. A significant decrease in IIEF-5 scores was noted at 3 months with an improvement at 6 and 12 months (Figure). Patients with an altered baseline sexual function were more likely to experience a significant postoperative decrease in erectile function scores. Continence rates (no pad use) ranged from 87.5 to 100%. Radical treatment rates ranged from 1.7% to 20.8%. The patient-reported outcomes (PRO) questionnaires used were not designed for a diverse population. CONCLUSIONS: Focal therapy led to changes in erectile function in most cases under the significance threshold of the patient-reported outcomes questionnaires used. Patients should be counseled according to their baseline erectile function. More research is warranted to detail aspects other than erectile function. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e821-e821 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Gaelle Fiard More articles by this author Aminah Chowdhury More articles by this author Aneirin Potter More articles by this author Celina Pook More articles by this author Daniel Kelly More articles by this author Mark Emberton More articles by this author Tet Yap More articles by this author Expand All Advertisement Loading ...