Undergoing Hormone Therapy Research Articles

Prognostic factors for stage IV hormone receptor-positive primary metastatic breast cancer

The purpose of this work was identify potential prognostic factors for survival in patients with primary metastatic hormone receptor-positive breast cancer undergoing endocrine therapy (ET) as first-line treatment. We investigated the clinical and pathological characteristics of 69 newly diagnosed stage IV hormone receptor-positive breast cancer patients undergoing ET between 1999 and 2009, and correlated these factors with disease progression and overall survival. Multivariate regression analysis revealed that progesterone receptor (PgR) positivity (hazard ratio (HR) 0.248; p = 0.001) and clinical benefits of first-line ET (HR 0.386; p = 0.008) were significant prognostic factors for survival. When first-line ET was not effective, patients for whom second-line ET was effective survived significantly longer than those for whom second-line ET was not effective (median survival time, 45.3 vs. 25.8 months; p = 0.0411). PgR positivity and clinical benefits of first-line ET were independent prognostic factors for patients with hormone receptor-positive stage IV breast cancer. Moreover, the benefits of second-line ET in patients with a tumor resistant to first-line ET suggests the existence of drug-specific resistance to ET.

Three-Year Postoperative Ultrasensitive Prostate-Specific Antigen Following Open Radical Retropubic Prostatectomy Is a Predictor for Delayed Biochemical Recurrence

BackgroundProstate-specific antigen (PSA) is the only independent predictor of biochemical recurrence (BCR) following radical prostatectomy (RP) subject to change over time. ObjectiveTo determine whether an ultrasensitive PSA measured at 3 yr following RP is a predictor of subsequent BCR. Design, setting, and participantsThere were 1197 consecutive men with clinically localized prostate cancer who underwent an open radical retropubic prostatectomy (ORRP) at a tertiary referral academic medical center. Exclusions included 107 men (8.9%) who developed a PSA level ≥0.2 ng/ml or underwent hormone therapy or radiation therapy (RT) within the first 3 r after surgery, 191 men (16%) who did not undergo a 3-yr ultrasensitive PSA assay, and 98 men (8.2%) who had PSA levels ≥0.1 and <0.2 at 3 yr. The remaining 801 men were stratified into two groups based on their ultrasensitive PSA level at 3 yr postoperatively: group 1, which consisted of patients whose PSA was ≤0.04 (n=765), and group 2, which consisted of patients whose PSA was >0.04 and <0.10 (n=36). MeasurementsDelayed BCR was the primary end point and represented those men in this cohort who developed a PSA level ≥0.2 or underwent salvage RT for a persistently rising PSA level after 3 yr of follow-up. Results and limitationsThe 7-yr cumulative BCR-free survival rate for groups 1 and 2 was 0.957 (95% confidence interval [CI], 0.920–0.978) and 0.654 (95% CI, 0.318–0.855), respectively. In multivariable Cox proportional hazards models, ultrasensitive PSA level at 3 yr remained the only significant predictor of delayed BCR (likelihood ratio χ2 for full model: 27.03; df=1; p < 0.001). A limitation of the study is that no uniform PSA assay was obtained. ConclusionsOur findings provide compelling evidence that an ultrasensitive PSA at 3 yr following RP provides useful insights into delayed BCR and is a source of reassurance for the overwhelming majority of men being followed for delayed recurrences.

Evaluation of the insulin-like growth factors (IGF) IGF-I and IGF binding protein 3 in patients at high risk for breast cancer

Our data suggest that serum concentrations of insulin-like growth factor I and insulin-like growth factor binding protein 3 do not correlate with breast cancer development.

Overexpression of nerve growth factor in peritoneal fluid from women with endometriosis may promote neurite outgrowth in endometriotic lesions

To investigate the role of the nerve growth factor (NGF) in the endometriosis-associated innervation in the development of endometriosis-associated symptoms, 41 peritoneal fluid samples (PF) from patients with surgically and histologically proven endometriosis and 20 PF from patients with other gynecologic conditions were analyzed with Western blot and a novel in vitro model using dorsal root ganglia (DRG) to show neuronal outgrowth; endometrial cells also were analyzed. The results suggest that the PF of endometriosis patients and endometriotic lesions have neurotropic properties, because the Western blot analysis and the cell culture stainings showed NGF expression, and the neurite outgrowth of DRG treated with PF of patients with endometriosis was significantly higher than when treated with PF of patients without endometriosis. Furthermore, blocking NGF with both anti-NGF and K252a leads to a significant decrease in neurite outgrowth.

Factors associated with cancer-related fatigue in breast cancer patients undergoing endocrine therapy in an urban setting: a cross-sectional study.

BackgroundFatigue is prevalent in breast cancer survivors and has profound effects on daily life. The interference of fatigue with endocrine therapy may be difficult to separate. This study investigates the prevalence and severity of fatigue and identifies the demographic, clinical, and lifestyle factors associated with cancer-related fatigue (CRF) in breast cancer patients undergoing endocrine therapy in an urban area.MethodsWomen with stage I-IIIA breast cancer were recruited and asked to participate (n = 371) in the study. The 315 women who responded to the questionnaire (84.9%), 54 (17.1%) had completed endocrine therapy and 261 (82.9%) were still undergoing endocrine therapy. The patients had been diagnosed at an average of 31 months prior to recruitment (range, 7 to 60 months); the average age was 48 (range, 33 to 72) years. The 11-point scale and Visual Analog Scale (VAS) were employed to quantify the level of fatigue experienced by the patients. Logistic regression analyses and a trend test method were performed to evaluate factors associated with CRF.ResultsAmong the 315 patients, 189 (60%) had experienced or were experiencing CRF during endocrine therapy. Logistic regression analysis was performed to identify factors associated with CRF, including BMI (body mass index), clinical stage, menopausal status, duration of endocrine therapy, physical activity, and diet. Factors unrelated to CRF were age, marital status, treatment, endocrine therapy drugs, alcohol intake, and smoking. The trend test method revealed an association between physical activity and dietary level and the intensity of CRF.ConclusionsThe present findings suggest that fatigue is an important problem in the majority of breast cancer patients during endocrine therapy. We found that BMI, clinical stage, menopausal status, duration of endocrine therapy, physical activity, and diet are associated with fatigue. Future research should focus on the impact factors of CRF and lifestyle in the management of breast cancer patients.

The effects of hypothyroidism on strength–duration properties of peripheral nerve

Axonal injury and/or demyelination commonly result in peripheral mononeuropathy, polyneuropathy or entrapment neuropathies in hypothyroidism. In this study, we aimed to measure the strength–duration time constants (SDTC) of motor and sensory fibres in patients with primary hypothyroidism before and after hormone replacement treatment. The motor and sensory SDTC and rheobase of 14 patients with overt hypothyroidism (TSH > 10 mg/ml, free T4 < normal range, with positive thyroid autoantibodies) and 10 age-matched healthy volunteers were measured following stimulation of left ulnar nerve at the wrist. Nerve conduction velocity studies revealed carpal tunnel syndrome in 3 of 14 patients. When the values of patients and control group were compared, motor and sensory rheobase, thresholds using 0.1 ms and 1 ms stimulus for motor and sensory fibres were significantly different ( p < 0.05). The values were bigger in patient group reflecting a higher threshold. When the values of patients were compared before and after therapy, motor and sensory rheobase, thresholds using 0.1 ms and 1 ms stimulus for motor and sensory fibres were significantly different ( p < 0.05). When the values of 10 of 14 patients who had undergone hormone therapy were compared with the control group, there wasn't any significant difference. Some reports suggest that axonal injury develop in hypothyroidism. Our results suggest that even in the absence of polyneuropathy findings, an increased threshold and in consequence an increased axonal excitability which can improve after hormone therapy may be present in overt hypothyroidism.

136 CHLORMADINONE ACETATE IS EFFECTIVE FOR HOT FLUSH IN ANDROGEN DEPRIVATION THERAPY

Purpose: To investigate the clinical efficacy of low-dose chlormadinone acetate (CMA) in prostate cancer patients who suffer from hot flushes that is a major side effect of androgen deprivation therapy. Methods: Our study included 32 prostate cancer patients who had severe hot flush after undergoing hormone therapy for more than 3 months. The average age of the patients was 72.5 years. In the beginning, patients received CMA at 100 mg orally per day. We defined the hot flush as disappeared, improved, or not improved. In patients with disappeared or improved symptoms, we decreased CMA dose to 50 mg per day, and after we reevaluated the effect, we decreased CMA dose to 25 mg per day. When hot flush appeared again at 25 mg per day, we returned the dose of CMA to 50 mg per day. In cases with no change for more than two months, we canceled the treatment of CMA. Results: Hot flush disappeared in 17 patients, improved in 10 patients, and did not improve in 5 patients (reduction in 84% of hot flush patients). The median time to hot flush reduction was 1.16 months. The effect of CMA was maintained at 25 mg per day in 19 patients and at 50 mg per day in 8 patients. No patients had prostate-specific antigen failure in the treatment of CMA. Conclusions: When hot flush appears during treatment with luteinizing hormone-releasing hormone agonist for prostate cancer, it seems that CMA can improve it immediately in most patients.

Hormone therapy in Brazilian postmenopausal women with chronic hepatitis C: a pilot study

Objective To evaluate liver function and hemostatic parameters in postmenopausal women who have chronic infection with the hepatitis C virus and climacteric symptoms and are undergoing hormone therapy (HT) (standard dose of transdermal continuous combined hormone therapy).Design Fifty out of 336 postmenopausal patients with chronic infection with the hepatitis C virus were selected. The non-inclusion criteria were other chronic or systemic liver diseases, severe vascular diseases, autoimmune diseases or malignant tumors. The patients were randomized into two groups: the HT group with 25 patients to be given transdermal hormone therapy (50 μg estradiol plus 170 μg norethisterone/day) and the control group with the other 25 patients (no medication). Hepatic tests (alanine aminotransferase, aspartate aminotransferase, gamma glutamyltransferase, total alkaline phosphatase, albumin, serum bilirubin) and hemostatic parameters (prothrombin time, factor V, fibrinogen) were evaluated at baseline and at 1, 4, 7 and 9 months of treatment.Results No significant changes in parameters were found in the comparison between the treated group and the controls, except for a decrease in total alkaline phosphatase (p = 0.002), presumably due to changes in bone remodelling.Conclusions There were no changes in liver function after a 9-month treatment with transdermal estradiol plus norethisterone in symptomatic postmenopausal patients with hepatitis C.

Simultaneous osteonecrosis and osteomyelitis in a patient with cancer of the breast

Breast cancer is generally managed surgically with adjuvant agents which include hormone therapy, chemotherapy, radiotherapy and bisphosphonate therapy. However, some of these adjuvant therapies may cause adverse events, including wound infection, neutropenia, bone marrow suppression and fever. The simultaneous presentation of osteonecrosis and osteomyelitis has not previously been described in patients with breast cancer undergoing hormone therapy and chemotherapy. We report a patient with breast cancer who developed bone infarcts in both legs as well as osteomyelitis in the right distal tibia after treatment which included a modified radical mastectomy, hormone therapy and chemotherapy. Simultaneous osteonecrosis and osteomyelitis should be considered in patients with breast cancer who are receiving chemotherapy and hormone therapy who present with severe bone pain, especially if there have been infective episodes during treatment.

Association of the polymorphisms CYP19 (TTTA)n in treatment response to hormone therapy based in aromatase inhibitors in breast cancer patients.

Abstract Abstract #3033 Background &amp;#x2028; Case-control studies have reported inconsistent results concerning breast cancer risk and polymorphisms in genes that control endogenous estrogen biosynthesis. We report findings from the first study in Mexican women examining associations between female with breast cancer and polymorphisms CYP19 (TTTA repeated polymorphism).&amp;#x2028; Methods &amp;#x2028; We conducted a study among 180 healthy women and 70 women with breast cancer underwent hormone therapy with aromatase inhibitor. DNA and questionnaire data was obtained. Tandem repeated (TTTA)n polymorphism in CYP19 gene was determined by PCR followed by electrophoresis on denaturalizing acrilamide gel stained with silver nitrate. Differences were visualized with Gel-Doc BioRad. Estrone, estradiol and FSH levels were measured by RIA and IRMA. We used likelihood-based statistical methods to examine allelic associations.&amp;#x2028; Results:&amp;#x2028; 250 women (age 55 ± 12 years) were included. BMI was 30 ± 7.1 Kg/m2. We found a distribution of different CYP19 allele frequencies. In healthy women the allele frequencies with 6 (32.7 %) and 7 (21.6 %) tandem repetitions were the most frequent, in women with breast cancer the alleles with 6(29%) and 10(26%) tandem repeated were the most frequent. A relationship between hormonal levels and number of (TTTA) repeated was not found. Anastrozol reduced significantly estrona and estradiol. Surpriseling we found in a patients with 10 or more (TTTA)n repeated an association with a mayor tumoral activity (p=0.04).&amp;#x2028; Conclusion &amp;#x2028; This study indicates that status of CYP19 &amp;gt;10 TTTA repeated might be related to increased breast cancer risk and with the clinical response (aromatase inhibitor). Because of this is the first study to report an association between CYP19 &amp;gt;10 TTTA repeated and treatment hormonal response in breast cancer. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3033.

Comparison of Health Related Quality of Life between Hormone Therapy and Radical Prostatectomy for Clinically Localized and Locally Advanced Prostate Cancer in Japanese Males

Objective: We investigated health related quality of life (HRQOL) in Japanese males who underwent hormone therapy (HT) or radical prostatectomy (RP) for localized and locally advanced prostate cancer. Patients and Methods: A total of 170 patients treated with HT (n = 101) or RP (n = 69) who completed the Japanese version of the 8-item Short-Form Health Survey and Expanded Prostate Cancer Index Composite for assessment of HRQOL were evaluated. Results: The physical and mental components scores for the HT group (47.1 and 49.2, respectively) were significantly lower than those for the RP group (49.3 and 50.4, respectively) (p < 0.0001 for both), as were the urinary bother and irritative scores (84.7 and 88.2 vs. 88.0 and 91.8, respectively) (p = 0.0091 and <0.0001, respectively), whereas the incontinence score in the HT group was significantly higher than that in the RP group (87.0 vs. 84.3, p = 0.0265). In addition, bowel summary, function, and bother scores in the HT group (89.3, 86.7, and 92.2, respectively) were significantly lower than those in the RP group (91.7, 89.2, and 94.1, respectively) (p = 0.0007, 0.0004 and 0.0057, respectively), whereas sexual summary and bother scores in the HT group (31.1 and 95.9, respectively) were significantly higher than those in the RP group (29.1 and 84.2, respectively) (p < 0.0001 for both), while, the function score in the HT group was significantly lower than that in the RP group (2.3 vs. 4.6, p < 0.0001). Conclusion: HRQOL scores for Japanese males treated with HT or RP for localized and locally advanced prostate cancer were generally good. General HRQOL was superior in the RP group, while disease-specific HRQOL scores showed some differences between the groups in regard to urinary, bowel, and sexual domains between the 2 groups.

Attitudes Toward Postmenopausal Long-Term Hormone Therapy

In this article we address the question of why postmenopausal women undergo hormone therapy. Thirty-five women aged 46 to 75 years living in Bremen (Germany) and taking postmenopausal hormones for at least 12 months were interviewed. Following Fritz Schütze, the interviews were analyzed according to a reconstructive analytical procedure. Five different types of users were identified. They differed from each other in terms of their reasons for using hormones, their expectations of this type of therapy, and their personal habits and circumstances, including an integrity-preserving attitude, a performance-oriented attitude, a searching attitude, a faith-in-medicine attitude, and a benefit-generalizing attitude. The interviews show that there is a need for target-oriented counseling, taking into account the individual attitudes toward menopause and postmenopausal hormone therapy.

Immunohistochemical detection of carcinoma in radical prostatectomy specimens following hormone therapy

Following hormone therapy, residual carcinoma is frequently difficult to identify on HE-stained prostatectomy specimens. The aim of the present study was therefore to investigate whole-mounted specimens obtained by radical prostatectomy from patients who had undergone hormone therapy. Formalin-fixed and paraffin-embedded specimens were immunostained with prostate secretory cell markers including prostate-specific antigen (PSA), P504S (alpha-methylacyl-coenzyme A racemase, AMACR), P501S (prostein), and prostate-specific membrane antigen (PSMA). Residual carcinoma was detected in 250 histological slides of 42 patients in a total of 497 slides from 45 patients. In five of 250 slides (2%), carcinoma was not able to be recognized on HE-stained slides, but was found on the immunohistochemistry slides. PSMA had reacted positively beyond a moderate degree in carcinoma from all patients. PSA was positive for carcinoma in most of the patients, while negative or minimal staining was observed in a small number of patients. Carcinoma was positively reactive with P504S and P501S in most of the patients, but was negatively reactive in a few. The Gleason score for a pretreatment needle biopsy correlated with P504S staining of the prostatectomy specimens. P504S and P501S had limited ability to identify degenerated carcinoma. PSMA was the most useful marker to identify carcinoma after hormone therapy.

Vaginosonographische Darstellung des Endometriums postklimakterischer Frauen

Vaginal sonography of the endometrium is a new method of controlling the substitution therapy with oestrogen and progesterone during the postmenopausal period. The advantages of transvaginal ultrasonic diagnosis are that the uterus can be seen from the fornix vaginae, that it is situated at close range, and that the examination can be conducted whether the bladder is filled or not. The differences in thickness and structure of the endometrium, and the limitation to the surrounding myometrium, enable sonographic detection of most of the changes of the endometrium during the postmenopausal period. In our first group of patients, we found an endometrial carcinoma in 2 out of the 60 women with postmenopausal metrorrhagia. The findings were confirmed histologically. Women who have regular bleedings while undergoing hormone therapy during the postmenopausal period, show signs of proliferation in the endometrium under oestrogen therapy and signs of secretion under progesterone therapy.

Change in International Prostate Symptom Score, prostrate‐specific antigen and prostate volume in patients with benign prostatic hyperplasia followed longitudinally

The natural history of benign prostatic hyperplasia (BPH) in Japan resembles Western studies in that symptoms worsen, improve or stabilize in equal proportions of patients. We sought to determine if this pattern persisted in men seeking care at a urology referral center and if worsening of symptoms was due to increase in prostate volume (PV). We reviewed the records of all BPH patients who attended the Urology Clinic of Sapporo Medical University Hospital, during December 2003 and June 2004 with the inclusion criterion that they have at least two PV and lower urinary tract symptoms measurements using the International Prostate Symptom Score (IPSS). Patients who had prostate cancer or who underwent hormone therapy or prostate surgery between the two visits were excluded. Correlation (Spearman's rank) was used to assess interrelationships among variables at baseline and follow up; the strength of association between change in IPSS and change in PV were modeled by multiple linear regression. Sixty-seven patients were eligible. Baseline PV correlated with residual urine volume (r = 0.37, P < 0.05) and prostate-specific antigen (PSA; r = 0.65, P < 0.001) but not IPSS (r =-0.16). PV increased in 46 (70%) men, remained the same in 10 and decreased in 11; in the former group, the mean prostate enlargement generally increased as baseline PV increased. In multiple linear regression models that included baseline IPSS, correlation between change in IPSS and change in PV was 0.47 (P = 0.05) based on 25 patients with measures at concurrent visits. Change in PV was also correlated with change in quality of life score (0.46, P = 0.02) but not with change in PSA (r = 0.38, P = 0.07, maximum flow rate (-0.24) or residual urine volume (-0.06). IPSS were not correlated with any laboratory measure of urinary function at baseline; however, change in IPSS was associated with change in PV. PV was also moderately correlated to PSA levels and residual urine volume at baseline.

Distant Metastasis of Prostate Cancer: Early Detection of Recurrent Tumor with Dual-Phase Carbon-11 Choline Positron Emission Tomography/Computed Tomography in Two Cases

Several types of recurrence may be detected by radiologic assessment after treatment in patients with prostate cancer. However, early detection of distant metastasis using positron emission tomography has so far never been published. We report two patients who underwent hormone therapy or surgical resection for prostate cancer. They developed distant metastases which were detected on whole body [C-11] choline positron emission tomography/computed tomography with significant elevation of serum PSA level. In one patient, recurrent tumor of the supraclavicular node (6 mm) diminished in size after subsequent hormone therapy. Surgical resection of recurrent tumor of the lung (12 mm) was performed in the other patient, the pathology of which confirmed the metastatic adenocarcinoma derived from the prostate. The recurrent tumor can be correctly detected by dual-phase whole body [C-11] choline positron emission tomography/computed tomography.

Similar efficacy of low and standard doses of transdermal estradiol in controlling bone turnover in postmenopausal women

Objectives. To investigate the effects of a low transdermal estradiol dose on bone metabolism and to compare it with both the standard dose and absence of treatment.Methods. In this study performed in a third-level academic center, 66 healthy postmenopausal women underwent hormone therapy (HT) with patches containing estradiol at standard (0.050 mg/day, HT50, 33 women) or low dosage (0.025 mg/day, HT25, 33 women) and 70 women were without treatment (NT). The values (mean of three samples) of several bone biochemical parameters were compared between groups after adjusting for confounding factors. Bone mineral density (BMD) was assessed (by dual-energy X-ray absorptiometry) in the spine and hip in all cases, and a second densitometry scan was performed in 44 women.Results. Bone turnover markers tended to show lower values in the treated groups, but significance was restricted to total alkaline phosphatase (NT vs. HT25, p < 0.05) and cross-linked N-telopeptides of type I collagen (NTX) (NT vs. HT25, p < 10−6; NT vs. HT50, p < 10−5). The loss of BMD observed in NT women, as assessed by the annual percentage change, was blocked in both the HT25 and HT50 women. No significant differences were detected between both HT groups.Conclusions. Low and standard dosages of transdermal estradiol were equally effective in controlling bone metabolism, as assessed by turnover markers. Additionally, NTX was confirmed as the most sensitive marker for detecting changes in bone resorption.

TREATMENT WITH PREDNISOLONE OF HORMONE-REFRACTORY PROSTATE CANCER

Fifteen patients 60 to 80 years old (a mean of 72 years) with hormone-refractory prostate cancer were treated with low dose prednisolone. All patients had previously undergone hormone therapy. Prostate specific antigen (PSA) values decreased in 11 cases (73%), of which 4 had PSA decreases of 50% or greater. Serum levels of DHEAS significantly decreased at 4 and 8 weeks after treatment (both intervals were p < 0.05 vs pretreatment). Of 8 patients with bone metastasis evaluation, 2 (25%) showed improvement of the lesion. In 5 patients (33%), relief of pain was observed one month after starting prednisolone. The one-year survival rate was 58%. The side effects were mild and manageable in an outpatient clinic.

Prevalência de distúrbios do sono na pós-menopausa

OBJETIVO: avaliar a prevalência das queixas de distúrbios do sono pela polissonografia em amostra de mulheres na pós-menopausa. MÉTODOS: foram selecionadas 33 mulheres na pós-menopausa com média de idade de 56 anos, índice de massa corporal médio de 27, tempo de pós-menopausa de 7,7 anos e índice de Kupperman de 17. Adotaram-se os seguintes critérios de inclusão: idade entre 50 e 65anos, no mínimo um ano de amenorréia e FSH plasmático superior ou igual a 30 mU/mL, sem uso de terapia hormonal prévia e exames laboratoriais normais. Foram excluídas as pacientes com doenças clínicas graves e/ou descompensadas, suspeita de câncer de endométrio e/ou mama; índice de massa corporal maior ou igual a 30 e uso de hipnóticos. As pacientes responderam a questionário específico contendo perguntas sobre as características do sono e foram submetidas a polissonografia completa durante uma noite inteira. Foram calculadas separadamente as freqüências em porcentagens das queixas de sono e dos diagnósticos polissonográficos. RESULTADOS: a prevalência de insônia subjetiva foi 61%, sendo que na polissonografia foi de 83%. A queixa de apnéia foi registrada em 23% e, na polissonografia, em 27%. A prevalência subjetiva de movimentos periódicos de pernas foi de 45% e a objetiva foi de 27%. CONCLUSÃO: houve alta prevalência de distúrbios do sono na pós-menopausa, em especial de insônia, apnéia e de movimentos periódicos das pernas. Nesta fase da vida, ocorre piora da qualidade do sono.

HISTOLOGICAL ALTERATIONS IN CAVERNOUS TISSUE AFTER RADICAL PROSTATECTOMY

Radical prostatectomy often results in erectile dysfunction because of lesions to the erectile nerves. In this study we evaluated histomorphological alterations in cavernous smooth muscle and collagen content after radical prostatectomy. A total of 19 patients between 57 and 69 years old with prostate adenocarcinoma and normal erectile function, as reported and validated by RigiScan (UroHealth Systems, Laguna Niguel, California) testing, underwent corpora cavernosa biopsy in the operating room before radical prostatectomy, and 2 and 12 months after surgery. No patient underwent hormone therapy before or after surgery and none was diabetic. Elastic fibers (manual counting), muscle specific actin (immunostaining) and collagen content (computerized morphometric imaging) were measured in the 3 biopsies. In all cases the first postoperative histological assessment revealed some disorganization. Trabecular elastic fibers (p <0.0003) and smooth muscle fibers were decreased and collagen content was significantly increased (p <0.0003) compared with preoperative biopsies. One year after surgery elastic fibers (p <0.0003) and smooth muscle fibers were decreased and collagen content was significantly increased (p <0.0003) compared with the first postoperative biopsy. Moreover, organized collagen and trabecular protocollagen deposits were increased. Progressive fibrosis in the corpora cavernosa after radical prostatectomy probably results from denervation and/or an ischemic process, which is caused in turn by the ligation of anomalous pudendal artery branches or of venous plexuses that drain to or from the corpora cavernosa. Fibrosis and the subsequent loss in elasticity and function of erectile tissue probably together cause erectile dysfunction.