Radical prostatectomy and active surveillance in prostate cancer; The evaluation of erectile function and depression

Aim: The aim of this study is to investigate whether active surveillance or radical prostatectomy in patients with localized prostate cancer has effect on erectile function and depression scores. Material and Method: Between years 2007 and 2010, patients diagnosed with localized prostate cancer after tests and received an active surveillance protocol and patients who underwent radical prostatectomy with similar preoperative clinical and pathological features were compared. Age, PSA, clinical stage, number of positive cores, Gleason score, time interval between diagnosis and the assessment of the patients in both groups were recorded. Beck depression scale and IIEF were filled by face to face interviews with patients. Results: There were 18 patients in active surveillance group, 17 patients in the radical prostatectomy group and mean follow-up periods were 16.8 (3-41), 59.35 (51-71) years, respectively. While age, PSA levels and Gleason scores were similar, the number of positive cores and clinical stages were different from each other. IIEF scores of patients in the active surveillance group were between 1-30, IIEF scores in the radical prostatectomy group were between 1-28, and the difference between the two groups was not statistically significant (p = 0.203). Beck Depression Scale scores ranged from 0-24 in the active surveillance group, and 0-16 in the radical prostatectomy group and the Beck Depression Scale scores were similar between groups (p = 0.157).Discussion: There is no difference between radical prostatectomy and active surveillance in terms of erectile function. Because of the lack of difference in terms of symptomatology of depression suggests that active surveillance does not load an additional psychological stress to patients.