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Preventative Function-sparing Radical Prostatectomy: Experience in a Tertiary Referral Centre.

Alexander Haese1, Markus Graefen1, Aliaksandra Pott2

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European Urology Oncology
|April 11, 2025
PubMed
Summary

Preventative radical prostatectomy (pRP) in men with high prostate cancer (PCa) fear improved quality of life, with no regrets or recurrence. This expert-performed procedure offers a potential option for well-informed patients seeking relief from PCa-related distress.

Keywords:
DistressFunctional outcomesPatient perspectivePreventative treatmentProstate cancerProstatectomy

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Area of Science:

  • Urology
  • Oncology
  • Men's Health

Background:

  • Outcomes of preventative radical prostatectomy (pRP) for prostate cancer (PCa) fear are not well-established.
  • Assessing functional and oncological results, alongside patient experiences, is crucial for understanding pRP's role.

Purpose of the Study:

  • To evaluate functional and oncological outcomes after pRP in a selected cohort.
  • To explore patient motivations, perspectives, and experiences following pRP.

Main Methods:

  • A cohort of seven patients undergoing pRP without prior PCa diagnosis was identified (2012-2021).
  • Validated questionnaires assessed functional and oncological outcomes.
  • Semistructured interviews gathered in-depth patient perspectives.

Main Results:

  • 71% of patients had PCa on final pathology (ISUP Grade Group 1 or 2).
  • Significant reduction in distress scores (7.7 to 1.3) was observed post-pRP.
  • All patients achieved full continence and erectile function for intercourse at ≥12 months, reporting improved quality of life.

Conclusions:

  • No patients regretted pRP, and all remained recurrence-free.
  • pRP may be a viable option for well-informed patients with severe PCa-related distress, outside standard guidelines.
  • Further legal framework development is recommended for this approach.