Does neoadjuvant hormonal therapy improve urinary function when given to men with large prostates undergoing prostate...

Area of Science:

• Urology
• Oncology
• Medical Physics

Background:

• Prostate brachytherapy is a common treatment for localized prostate cancer.
• Men with larger prostates (≥50 cc) may experience different outcomes and side effects.
• Neoadjuvant hormonal therapy is sometimes used to reduce prostate size before brachytherapy.

Purpose of the Study:

• To evaluate the impact of neoadjuvant hormonal therapy on urinary function in men with large prostates (≥50 cc) undergoing prostate brachytherapy.
• To assess the incidence of urinary retention and the need for transurethral prostate resection.

Main Methods:

• A total of 395 men with prostate volume ≥50 cc were analyzed.
• Patients received either 3 months of neoadjuvant hormonal therapy (204 men) or brachytherapy alone (191 men).
• Urinary function was assessed using the International Prostate Symptom Score (IPSS), urinary retention rates, and transurethral prostate resection rates.

Main Results:

• Neoadjuvant hormonal therapy significantly reduced prostate volume (mean decrease from 72.9 cc to 54.3 cc).
• Urinary retention occurred in 12.3% of men with hormonal therapy vs. 8.4% without (p=0.207).
• Transurethral prostate resection rates were similar between groups (5.9% with vs. 5.8% without hormonal therapy).

Conclusions:

• Neoadjuvant hormonal therapy is most beneficial for men with large prostates and an International Prostate Symptom Score of 15 or greater undergoing brachytherapy.
• The therapy effectively reduces prostate size without adversely affecting urinary outcomes or requiring more transurethral resections.