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Influence of radical prostatectomy on serum hormone levels.
J Urol. 1998 Aug; 160(2):449-53.JU

Abstract

PURPOSE

The influence of radical prostatectomy on the hypothalamic pituitary axis has not been well studied. It is also unclear how alterations in serum androgen levels that result from surgical removal of the prostate might influence the recovery of libido and sexual function following radical prostatectomy. We determined the influence of radical prostatectomy on the hypothalamic pituitary testicular axis of 63 men with clinically localized prostate cancer treated only with radical prostatectomy.

MATERIALS AND METHODS

A total of 63 healthy men 43 to 67 years old were enrolled in this prospective study. Phlebotomy was performed immediately before and 1 year following radical retropubic prostatectomy. Sera were stored frozen and analyzed as a group at the end of the study. We measured serum testosterone, percent free testosterone, dihydrotestosterone (DHT), estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), sex hormone binding globulin and prolactin.

RESULTS

Following radical prostatectomy there was a statistically significant increase in serum testosterone, free testosterone, estradiol, LH and FSH (p <0.0001), and statistically significant decrease in serum DHT (p <0.0001). No difference was noted in serum sex hormone binding globulin or prolactin levels. There was no statistically significant correlation between any serum hormone and sample storage time, patient age or prostate volume that could limit potential bias in study design. Serum hormone changes did not correlate with pathological stage or histological grade for this group of patients.

CONCLUSIONS

Radical prostatectomy influences the hypothalamic pituitary axis by increasing serum testosterone, percent free testosterone, estradiol, LH and FSH while decreasing serum DHT levels. These findings suggest that the sexual dysfunction associated with radical prostatectomy cannot be explained by androgen deficiency alone. These data further suggest that the normal prostate and/or prostate neoplasm could secrete a substance or substances that give negative feedback control to pituitary gonadotropin secretion. Further investigation is warranted to identify this substance or substances.

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Authors+Show Affiliations

Miller LR
Department of Medicine, The Johns Hopkins School of Medicine and James Buchanan Brady Urological Institute, Baltimore, Maryland, USA.
Partin AW
No affiliation info available
Chan DW
No affiliation info available
Bruzek DJ
No affiliation info available
Dobs AS
No affiliation info available
Epstein JI
No affiliation info available
Walsh PC
No affiliation info available

MeSH

AdultAge FactorsAgedAndrogensDihydrotestosteroneEstradiolFeedbackFollicle Stimulating HormoneGonadal Steroid HormonesGonadotropins, PituitaryHumansHypothalamo-Hypophyseal SystemLibidoLuteinizing HormoneMaleMiddle AgedProlactinProspective StudiesProstateProstatectomyProstatic NeoplasmsSex Hormone-Binding GlobulinSexual BehaviorSexual Dysfunction, PhysiologicalTestisTestosterone

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

9679896

Citation

Miller, L R., et al. "Influence of Radical Prostatectomy On Serum Hormone Levels." The Journal of Urology, vol. 160, no. 2, 1998, pp. 449-53.
Miller LR, Partin AW, Chan DW, et al. Influence of radical prostatectomy on serum hormone levels. J Urol. 1998;160(2):449-53.
Miller, L. R., Partin, A. W., Chan, D. W., Bruzek, D. J., Dobs, A. S., Epstein, J. I., & Walsh, P. C. (1998). Influence of radical prostatectomy on serum hormone levels. The Journal of Urology, 160(2), 449-53.
Miller LR, et al. Influence of Radical Prostatectomy On Serum Hormone Levels. J Urol. 1998;160(2):449-53. PubMed PMID: 9679896.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of radical prostatectomy on serum hormone levels. AU - Miller,L R, AU - Partin,A W, AU - Chan,D W, AU - Bruzek,D J, AU - Dobs,A S, AU - Epstein,J I, AU - Walsh,P C, PY - 1998/7/29/pubmed PY - 1998/7/29/medline PY - 1998/7/29/entrez SP - 449 EP - 53 JF - The Journal of urology JO - J Urol VL - 160 IS - 2 N2 - PURPOSE: The influence of radical prostatectomy on the hypothalamic pituitary axis has not been well studied. It is also unclear how alterations in serum androgen levels that result from surgical removal of the prostate might influence the recovery of libido and sexual function following radical prostatectomy. We determined the influence of radical prostatectomy on the hypothalamic pituitary testicular axis of 63 men with clinically localized prostate cancer treated only with radical prostatectomy. MATERIALS AND METHODS: A total of 63 healthy men 43 to 67 years old were enrolled in this prospective study. Phlebotomy was performed immediately before and 1 year following radical retropubic prostatectomy. Sera were stored frozen and analyzed as a group at the end of the study. We measured serum testosterone, percent free testosterone, dihydrotestosterone (DHT), estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), sex hormone binding globulin and prolactin. RESULTS: Following radical prostatectomy there was a statistically significant increase in serum testosterone, free testosterone, estradiol, LH and FSH (p <0.0001), and statistically significant decrease in serum DHT (p <0.0001). No difference was noted in serum sex hormone binding globulin or prolactin levels. There was no statistically significant correlation between any serum hormone and sample storage time, patient age or prostate volume that could limit potential bias in study design. Serum hormone changes did not correlate with pathological stage or histological grade for this group of patients. CONCLUSIONS: Radical prostatectomy influences the hypothalamic pituitary axis by increasing serum testosterone, percent free testosterone, estradiol, LH and FSH while decreasing serum DHT levels. These findings suggest that the sexual dysfunction associated with radical prostatectomy cannot be explained by androgen deficiency alone. These data further suggest that the normal prostate and/or prostate neoplasm could secrete a substance or substances that give negative feedback control to pituitary gonadotropin secretion. Further investigation is warranted to identify this substance or substances. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/9679896/Influence_of_radical_prostatectomy_on_serum_hormone_levels_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5347(01)62922-7 DB - PRIME DP - Unbound Medicine ER -