Preoperative high serum total testosterone levels predict preserved postoperative sexual function in patients after...

Area of Science:

• Urology
• Oncology
• Endocrinology

Background:

• Robot-assisted radical prostatectomy (RARP) is a standard treatment for prostate cancer.
• Preoperative hormonal status, specifically total testosterone levels, may influence outcomes after RARP.
• Understanding these associations can optimize patient selection and surgical strategy.

Purpose of the Study:

• To investigate the relationship between preoperative total testosterone levels and postoperative sexual function.
• To assess the impact of preoperative total testosterone on oncological prognosis after RARP.
• To evaluate the efficacy of nerve-sparing procedures in relation to testosterone levels.

Main Methods:

• A cohort of 233 patients undergoing RARP was analyzed.
• Patients were stratified into low (<3.0 ng/mL) and high (≥3.0 ng/mL) preoperative total testosterone groups.
• Sexual function was assessed using validated questionnaires and potency rates; oncological outcomes by biochemical recurrence.

Main Results:

• No significant difference in overall sexual function was observed between high and low testosterone groups.
• In nerve-sparing RARP cases, significant sexual function preservation was noted exclusively in the high testosterone group.
• The high testosterone group demonstrated superior biochemical recurrence-free survival (p=0.008).

Conclusions:

• High preoperative total testosterone is associated with preserved sexual function following nerve-sparing RARP.
• Patients with high testosterone levels exhibit better oncological outcomes post-RARP.
• Nerve-sparing interventions may be particularly beneficial for patients with high total testosterone.