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Introduction: The aim of this study was to evaluate radiologically the effects of long-term luteinizing hormone-releasing hormone (LHRH) agonist therapy on extraocular muscle thickness, retrobulbar orbital fat (ROF), and the optic nerve (ON) in prostate cancer (PCa) patients. Methods: The retrospective study included patients with primary or recurrent PCa who received androgen deprivation therapy (ADT) for at least 12 months. Each patient underwent gallium-68 prostate-specific membrane antigen positron emission tomography-computed tomography both before and at the end of the 12-month treatment. Thickness of the ON, lateral rectus muscle, medial rectus muscle, superior rectus muscle, and inferior rectus muscle were measured by using the coronal CT sections in soft tissue window. ROF, ocular protrusion, and ON length were measured in sagittal and coronal planes. Changes in these anatomical structures induced by LHRH analogs were investigated by comparing pre- and post-treatment measurements. Results: A total of 57 patients were included in the study. Median PSA and TT values ​​of the patients before treatment were 36.5 (range, 19.6–51.2) ng/mL and 614.0 (range, 472.0–743.0) ng/dL, respectively, and these values ​​decreased significantly after the treatment (10.6 [range, 5.2–14.2] ng/mL and 36.5 [range, 19.6–51.2] ng/dL, respectively, p < 0.001 for both). After the treatment, there was a statistically significant decrease in the areas of inferior rectus muscle, superior rectus muscle, lateral rectus muscle, and medial rectus muscle (p < 0.001 for all), while significant increases were observed in ROF (11.9%, p < 0.001) and ON thickness (14.3%, p = 0.004). The amount of ocular protrusion also showed a significant increase of approximately 14% after the treatment (14.0 [range, 12.0–16.0] mm vs. 16.0 [range, 14.0–17.2] mm, p < 0.001). Discussion/Conclusion: Our findings, for the first time in the literature, indicated that ADT causes a decrease in extraocular muscle mass and an increase in ROF with ocular protrusion. It can be asserted that these changes are similar to the changes in skeletal muscle and fat mass in other body parts. Further studies with a higher level of evidence are needed to clinically evaluate the increase in ocular protrusion and ON enlargement, which are likely to be caused by the increase in ROF. [ABSTRACT FROM AUTHOR]

Post-prostatectomy stress incontinence (PPI) is an important health problem for patients with radical prostatectomy history. Duloxetine is a common drug, used in PPI with the out of indications in most countries. In this study, we aimed to evaluate the prophylactic effect of duloxetine administration in PPI during the early postoperative period in patients undergoing laparoscopic radical prostatectomy (LRP). The retrospective study included 209 patients who underwent LRP. Patients were divided into two groups: Group I (n=96) was initiated on pelvic floor exercises (PFE) + duloxetine in the early postoperative period and continued this regimen for a total of 12 weeks and Group II (n=113) only performed PFE for 12 weeks after surgery. Exclusion criteria were as follows: a history of neuromuscular dysfunction of bladder, post-prostatectomy urge incontinence, receiving adjuvant radiotherapy during the 12-week period, prior anti-incontinence surgery, and post-voiding urine>100 ml. The prevalence rates of urinary incontinence measured at the time of urinary catheter removal (baseline) and at weeks 3, 6, and 12 after surgery and the number of wet pads per day were compared. The study included 209 patients with a mean age of 60.68 ± 7.16 years. Baseline urinary continence rates were similar in Group I and Group II (29.2% vs. 35.4%, p=0.338). At 12 weeks, although PPI rates have decreased in both groups, there was no difference between Group I and Group II (15.6% vs. 24.8%, p=0.103). Administration of prophylactic duloxetine in the early postoperative period, which started without regard to the positivity of PPI, is not significantly effective to early postoperative urinary continence recovery. [ABSTRACT FROM AUTHOR]

In conclusion, this study has shown that substantial portions of the patients still feel severe pain during the prostate biopsy, and we believe that mpMRI technology should be used as a standard before biopsy for the detection of patients with high-pain risk. In this current study, which included a total of 108 patients, standard prostate biopsy plus target biopsy was applied as a combined method and an average of 14.6 cores were sampled per patient. [Extracted from the article]