Prostatectomy Linked to More Incontinence, Sexual Dysfunction at 5 Years

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

Men who undergo prostatectomy for localized prostate cancer face higher risk for some functional deficits at 5 years than those who receive other treatments, a JAMA study finds.

Roughly 2000 men completed health questionnaires after being treated for localized prostate cancer. Men with favorable-risk disease received active surveillance, nerve-sparing prostatectomy, external beam radiation therapy (EBRT), or low-dose-rate brachytherapy, while those with unfavorable-risk disease underwent prostatectomy or EBRT with androgen deprivation therapy.

Most differences in functional outcomes (e.g., urinary, bowel, or sexual function) across the treatments were minimal at 5 years' follow-up. However, men who underwent prostatectomy reported worse urinary incontinence through 5 years, relative to those who received other treatments. In addition, men with unfavorable-risk disease reported worse sexual function with prostatectomy than with EBRT plus androgen deprivation therapy.

Of note, prostate-cancer survival did not differ across the treatment groups.