MALE AND FEMALE SEXUAL FUNCTION AND DYSFUNCTION; ANDROLOGY
1985
Editorial Comment: A total of 14 institutions across 3 continents combined data to assess the risk of positive surgical margins. Using logistic regression and propensity score methods to control for various clinical and pathological variables, laparoscopic and robotic approaches had significantly lower risks of positive surgical margins compared to open radical prostatectomy. Margin rates were also lower in high volume vs low volume centers for the minimally invasive approaches. It is safe to conclude that a laparoscopic or robotic approach to prostatectomy confers local disease control in experienced hands. Jeffrey A. Cadeddu, MD
Suggested Reading Smith JA Jr, Chan RC, Chang SS et al: A comparison of the incidence and location of positive surgical margins in robotic assisted laparoscopic radical prostatectomy and open retropubic radical prostatectomy. J Urol 2007; 178: 2385.
Male and Female Sexual Function and Dysfunction; Andrology Re: Low Incidence of New Biochemical Hypogonadism after Intensity Modulated Radiation Therapy for Prostate Cancer S. Markovina, D. C. Weschenfelder, H. Gay, A. McCandless, B. Carey, T. DeWees, N. Knutson and J. Michalski Department of Radiation Oncology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri, and Hospital Sa˜o Lucas, lica de Porto Alegre, Porto Alegre, Brazil Pontifı´cio Universidade Cato Pract Radiat Oncol 2014; 4: 430e436.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.03.066 available at http://jurology.com/ Editorial Comment: These data suggest that that there is a temporary and transient decrease in total serum testosterone (less than 300 ng/dl) at 6 months following completion of intensity modulated radiation therapy, with return of serum testosterone levels to baseline at 1 year. This is an interesting observation and requires further study to understand the mechanism of this short-term reduction in serum testosterone. Allen D. Seftel, MD
Re: Testosterone Replacement Therapy in Men with Prostate Cancer: A Time-Varying Analysis A. L. Kaplan, A. T. Lenis, A. Shah, J. Rajfer and J. C. Hu Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, California J Sex Med 2015; 12: 374e380.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.03.067 available at http://jurology.com/ Editorial Comment: The use of testosterone replacement therapy (TRT) in men with prostate cancer is controversial, given concerns regarding androgen related cancer progression. Using linked Surveillance, Epidemiology and End Results-Medicare data, the authors identified 149,354 men diagnosed with prostate cancer from 1991 to 2007. Subjects undergoing TRT were stratified by duration of treatment. Cox proportional hazards model was constructed to assess the effect of injectable TRT exposure on outcomes. Outcomes were overall mortality, prostate cancer specific mortality and use of salvage androgen deprivation therapy. Men undergoing TRT, regardless of duration, did not experience increased overall mortality or prostate cancer specific mortality
1986
MALE AND FEMALE SEXUAL FUNCTION AND DYSFUNCTION; ANDROLOGY
(all HR less than 1.0, all p 0.002). The authors found no difference in use of salvage androgen deprivation therapy in the 30-day or less group or the 31 to 60-day group compared to no TRT (HR 1.23 and 1.05, p ¼ 0.06 and 0.81, respectively), whereas it was less for men on long-term TRT (HR 0.70, p ¼ 0.04). These data are reassuring and continue to support the fact that TRT does not appear to have a negative impact on prostate cancer. Allen D. Seftel, MD
1985
Editorial Comment: A total of 14 institutions across 3 continents combined data to assess the risk of positive surgical margins. Using logistic regression and propensity score methods to control for various clinical and pathological variables, laparoscopic and robotic approaches had significantly lower risks of positive surgical margins compared to open radical prostatectomy. Margin rates were also lower in high volume vs low volume centers for the minimally invasive approaches. It is safe to conclude that a laparoscopic or robotic approach to prostatectomy confers local disease control in experienced hands. Jeffrey A. Cadeddu, MD
Suggested Reading Smith JA Jr, Chan RC, Chang SS et al: A comparison of the incidence and location of positive surgical margins in robotic assisted laparoscopic radical prostatectomy and open retropubic radical prostatectomy. J Urol 2007; 178: 2385.
Male and Female Sexual Function and Dysfunction; Andrology Re: Low Incidence of New Biochemical Hypogonadism after Intensity Modulated Radiation Therapy for Prostate Cancer S. Markovina, D. C. Weschenfelder, H. Gay, A. McCandless, B. Carey, T. DeWees, N. Knutson and J. Michalski Department of Radiation Oncology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri, and Hospital Sa˜o Lucas, lica de Porto Alegre, Porto Alegre, Brazil Pontifı´cio Universidade Cato Pract Radiat Oncol 2014; 4: 430e436.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.03.066 available at http://jurology.com/ Editorial Comment: These data suggest that that there is a temporary and transient decrease in total serum testosterone (less than 300 ng/dl) at 6 months following completion of intensity modulated radiation therapy, with return of serum testosterone levels to baseline at 1 year. This is an interesting observation and requires further study to understand the mechanism of this short-term reduction in serum testosterone. Allen D. Seftel, MD
Re: Testosterone Replacement Therapy in Men with Prostate Cancer: A Time-Varying Analysis A. L. Kaplan, A. T. Lenis, A. Shah, J. Rajfer and J. C. Hu Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, California J Sex Med 2015; 12: 374e380.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.03.067 available at http://jurology.com/ Editorial Comment: The use of testosterone replacement therapy (TRT) in men with prostate cancer is controversial, given concerns regarding androgen related cancer progression. Using linked Surveillance, Epidemiology and End Results-Medicare data, the authors identified 149,354 men diagnosed with prostate cancer from 1991 to 2007. Subjects undergoing TRT were stratified by duration of treatment. Cox proportional hazards model was constructed to assess the effect of injectable TRT exposure on outcomes. Outcomes were overall mortality, prostate cancer specific mortality and use of salvage androgen deprivation therapy. Men undergoing TRT, regardless of duration, did not experience increased overall mortality or prostate cancer specific mortality
1986
MALE AND FEMALE SEXUAL FUNCTION AND DYSFUNCTION; ANDROLOGY
(all HR less than 1.0, all p 0.002). The authors found no difference in use of salvage androgen deprivation therapy in the 30-day or less group or the 31 to 60-day group compared to no TRT (HR 1.23 and 1.05, p ¼ 0.06 and 0.81, respectively), whereas it was less for men on long-term TRT (HR 0.70, p ¼ 0.04). These data are reassuring and continue to support the fact that TRT does not appear to have a negative impact on prostate cancer. Allen D. Seftel, MD
