The impact of radical prostatectomy (rp) on testosterone (t) levels

Abstract Introduction Severe illness is associated with a decrease in T levels and in particular, radical cystectomy has previously been shown to result in a decrease in T levels. There is a lack of data on the impact of RP on T levels. This analysis aimed to address this question. Objective To evaluate the impact of RP on T levels. Methods The study population included (i) men who underwent RP (ii) with morning total T (TT) levels pre and post-RP (iii) measured using LCMS. We considered men who had TT levels measured ≤ 12 months before and after RP. Patients with radiation therapy, androgen deprivation therapy, or T therapy pre or post-RP were excluded. Differences in TT level pre and post-RP were measured. Low total T was defined as total T levels < 300 ng/dL. Difference ≥ 100 ng/dL between pre and post-RP was considered clinically significant. Multivariable analysis was performed to define predictive factors associated with low T after RP. A p-value <0.05 was considered statistically significant. Results 569 patients were analyzed. Mean age was 62 ± 7 years, median pre-RP PSA level was 6.1 (4.3, 8.9) ng/mL, mean pre-RP TT level 402 ± 172 ng/dL. Median Gleason score (GS) was 7 (6,7). Post-RP, the mean TT levels were 425 ± 169 ng/dL. 30% of men had low T pre-RP, 27% post-RP. No significant difference was observed between the rate of low T pre and post-RP. 13% of the men had a significant decrease and 23% a significant increase in total T levels between pre and post-RP. After multivariable logistic regression assessments, lower baseline T was a predictor associated with low T post-RP (Pre-RP Testosterone (per 100 ng/dL decrease) OR = 3.96, 95% CI = 3.03-5.18). Conclusions Approximately 1 in 4 men with prostate cancer and RP had low T before and after surgery in our cohort. One tenth of men had a significant drop in TT level and about a quarter had a significant increase. Only lower pre-RP TT levels were a significant predictor of low T post-RP. Disclosure No