Does prior surgical interventional therapy for BPH affect the oncological or functional outcomes after primary whole-gland prostate cryoablation for localized prostate cancer?

• Published in: Prostate cancer and prostatic diseases 2021-06, Vol.24 (2), p.507-513
• Main Authors: ElShafei, Ahmed, DeWitt-Foy, Molly, Calaway, Adam, Fernstrum, Austin J., Hijaz, Adonis, Muncey, Wade, Alfahmy, Anood, Mahran, Amr, Mishra, Kirtishri, Stephen Jones, J., Polascik, Thomas J.
• Format: Article
• Language: English
• Subjects: 692/308/409; 692/699/67; Ablation; Ablation (Surgery); Aged; Biomedical and Life Sciences; Biomedicine; Biopsy; Cancer; Cancer Research; Care and treatment; Comparative analysis; Cryosurgery; Cryosurgery - methods; Diseases; Erectile dysfunction; Fistula; Fistulae; Follow-Up Studies; Glands; Humans; Hyperplasia; Impotence; Male; Oncology, Experimental; Patients; Preoperative Care; Prognosis; Prospective Studies; Prostate cancer; Prostatic Hyperplasia - pathology; Prostatic Hyperplasia - surgery; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery; Relapse; Reproductive Medicine; Retention; Risk; Statistical analysis; Surgery; Survival; Survival analysis; Survival Rate; Therapy; Thermotherapy; Transurethral Resection of Prostate - methods; Urinary incontinence; Urinary retention
• ISSN: 1365-7852; 1476-5608
• DOI: 10.1038/s41391-020-00306-z

Background To assess whether prior interventional treatment for benign prostatic hyperplasia (BPH) influences oncologic or functional outcomes following primary whole-gland prostate cryoablation. Methods Among 3831 men with prostate cancer who underwent primary whole-gland prostate cryoablation, we identified 160 with a history of prior BPH interventional therapy including transurethral needle ablation ( n  = 6), transurethral microwave thermotherapy ( n  = 9), or transurethral resection of the prostate ( n  = 145). Patients with a history of medically treated or unspecified BPH therapy were excluded from the study. Oncological and functional outcomes were compared between men with and without prior BPH interventional therapy. Results In unadjusted analyses, prior interventional BPH therapy was associated with higher risks of postoperative urinary retention (17.5% vs. 9.6%, p  = 0.001) and new-onset urinary incontinence (39.9% vs. 19.4%, p  > 0.001) compared with no prior therapy. Interventional BPH therapy was not correlated with the risk of developing a rectourethral fistula ( p  = 0.84) or new-onset erectile dysfunction (ED) at 12 months ( p  = 0.08) following surgery. On multivariable regression, prior interventional BPH therapy was associated with increased risk of urinary retention (OR 1.9, 95%, p  = 0.015) and new-onset urinary incontinence (OR 2.13, p