Incontinence, Impotence Risk After RP Linked to Metabolic Syndrome

SAN FRANCISCO—Men with metabolic syndrome (MetS) are at elevated risk of urinary incontinence and erectile dysfunction following radical prostatectomy (RP), investigators reported at the American Urological Association 2018 annual meeting.

In a study of 5758 men who underwent RP for prostate cancer, Alessandro Morlacco, MD, of Mayo Clinic in Rochester, Minnesota, and colleagues found that the proportion of patients who were continent (no pad use) at 1 year was significantly lower among those with than without MetS prior to surgery (75.4% vs 82.6%). The proportion of patients who achieved erections with or without therapy at 1 year also was significantly lower in the MetS group (41.8% compared with 18.8% impotent prior to therapy in the MetS group vs 55.8% compared with 11.3% impotent prior to therapy in the non-MetS group).

The MetS and no-MetS groups had similar rates of other early and late surgical complications, according to the investigators, with the only difference seen in wound infections (5.8% vs 3.9%).

Of the 5758 men in the study, 1021 (17.7%) had MetS. At the time of surgery, patients had a median age of 62 years and median PSA level of 5.4 ng/mL.

The authors concluded that RP is safe in both MetS and non-MetS groups, but the higher risk of urinary incontinence and erectile dysfunction among RP patients with MetS “should be an important aspect of these patients’ counseling, and warrant further development of risk-reducing strategies.”

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Reference

Morlacco A, Dal Moro F, Rangel LJ, et al. Impact of metabolic syndrome on functional outcomes and complications after radical prostatectomy. Data presented in poster format at the American Urological Association 2018 annual meeting, San Francisco, May 18–21. Abstract MP11-06.