Effect of androgen deprivation therapy after radical prostatectomy on urinary symptoms

Salvage intermittent ADT has been demonstrated to be a potentially effective treatment option for BCR following RP. Although ADT improves urinary symptoms by reducing prostate volume, no studies have been conducted to investigate its effect on urinary symptoms after RP. We retrospectively examined changes in urinary symptoms in patients who developed BCR after RP and underwent salvage intermittent ADT.

OABSS, IPSS, and ICIQ-SF scores were compared before ADT, 3 months after the start of ADT, 12 months after the start of ADT, at the end of ADT, and 1 year after the end of ADT in patients who received intermittent ADT following RARP. In addition, changes in urinary symptoms were compared between the group with pre-ADT testosterone levels <400 ng/dL (low testosterone group) and the group with levels ⩾400 ng/dL (high testosterone group).

Three months after the initiation of ADT, the IPSS total score, IPSS urine storage score, and ICIQ-SF score were significantly higher compared to their pre-treatment levels. In the low testosterone group, the ICIQ-SF score was significantly worse only at 12 months after the start of ADT compared to before the start of ADT. In the high testosterone group, the IPSS total score, storage IPSS score, and ICIQ-SF score were significantly higher at both 3 and 12 months after initiating ADT compared to their pre-treatment levels.

ADT for BCR after RARP has been shown to significantly worsen urinary storage symptoms while not improving voiding symptoms, particularly in patients with high testosterone levels pre-ADT.