Med Bull Sisli Etfal Hosp. 2023; 57(2): 210-215 | DOI: 10.14744/SEMB.2023.32549

The Clinical Impact of Physical Activity on the Diagnosis of Prostate Cancer and Postprostatectomy Functional Outcomes in the Elderly

Ozgur Kazan¹, Mustafa Kaan Akalin², Meftun Culpan², Gokhan Atis², Asif Yildirim^2
1Department of Urology, Kutahya Health Sciences University, Faculty of Medicine, Kutahya, Türkiye
²Department of Urology, Istanbul Medeniyet University, Faculty of Medicine, Istanbul, Türkiye

Objectives: The effect of physical activity on prostate cancer is controversial. We aimed to investigate the effect of physical activity on prostate cancer detection and functional outcomes after radical prostatectomy.
Methods: Between 2019 and 2020, 166 patients who underwent prostate biopsy were included. The physical activity scores of patients were evaluated by the Physical Activity Scale for the Elderly (PASE) questionnaire before the procedure. PASE scores were compared between the patients with and without prostate cancer and local and metastatic aggressiveness of cancer. Patients who underwent radical prostatectomy were followed up for 12 months to analyze the effect of physical activity on erectile dysfunction (ED) and urinary incontinence (UI).
Results: There was no significant difference between patients with and without prostate cancer in terms of PASE scores (187.7 vs. 195.5, p=0.665). PASE scores were also similar when separated according to D’Amico risk classification and metastatic events. Twenty-seven patients who underwent radical prostatectomy were evaluated in terms of functional outcomes at the first year of surgery. PASE scores of the patients with severe ED were lower than mild-moderate ED, but no statistically significant difference was observed (197.0 vs. 268.5, p=0.267). Patients with persistent UI had a significantly lower PASE score overall than continent patients (128.3 vs. 271.1, p=0.001), and PASE score was the only independent predictor of UI following radical prostatectomy.
Conclusion: The effect of physical activity on prostate cancer development or aggressiveness could not be determined. Physical activity was associated with a reduced risk of UI following radical prostatectomy.

Keywords: Erectile dysfunction, PASE, physical activity, prostate cancer, urinary incontinence

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Fiziksel Aktivitenin Yaþlýlarda Prostat Kanseri Teþhisi ve Prostatektomi Sonrasý Fonksiyonel Sonuçlara Klinik Etkisi

Ozgur Kazan¹, Mustafa Kaan Akalin², Meftun Culpan², Gokhan Atis², Asif Yildirim^2
1Kütahya Saðlýk Bilimleri Üniversitesi, Týp Fakültesi, Üroloji Ana Bilim Dalý, Kütahya
²Ýstanbul Medeniyet Üniversitesi, Týp Fakültesi, Üroloji Ana Bilim Dalý, Ýstanbul

Amaç: Fiziksel aktivitenin prostat kanseri üzerindeki etkisi tartýþmalýdýr. Fiziksel aktivitenin prostat kanseri tanýsý ve radikal prostatektomi sonrasý fonksiyonel sonuçlara etkisini araþtýrmayý amaçladýk.
Gereç ve yöntemler: 2019-2020 yýllarý arasýnda prostat biyopsisi yapýlan 166 hasta çalýþmaya dahil edildi. Hastalarýn fiziksel aktivite skorlarý iþlem öncesinde yaþlýlar için fiziksel aktivite ölçeði (PASE) anketi ile deðerlendirildi. PASE skorlarý prostat kanseri olan ve olmayan hastalar ile kanserin lokal ve metastatik agresifliði arasýnda karþýlaþtýrýldý. Radikal prostatektomi yapýlan hastalar, fiziksel aktivitenin erektil disfonksiyon (ED) ve üriner inkontinans (UI) üzerindeki etkisini analiz etmek için 12 ay boyunca takip edildi.
Bulgular: PASE skorlarý açýsýndan prostat kanseri olan ve olmayan hastalar arasýnda anlamlý bir fark yoktu (187,7 vs 195,5, p= 0,665). D'Amico risk sýnýflandýrmasýna ve metastatik olaylara göre ayrýldýðýnda PASE skorlarý yine benzerdi. Radikal prostatektomi uygulanan 27 hasta cerrahinin ilk yýlýnda fonksiyonel sonuçlar açýsýndan deðerlendirildi. Þiddetli ED'li hastalarýn PASE skorlarý hafif-orta ED'den daha düþüktü, ancak istatistiksel olarak anlamlý bir fark gözlenmedi (197,0 vs 268,5, p= 0,267). Kalýcý inkontinansý olan hastalarýn genel olarak kontinan hastalara göre önemli ölçüde daha düþük bir PASE skoru vardý (128,3 vs 271.1, p=0,001) ve PASE skoru radikal prostatektomiyi takiben üriner inkontinansýn tek baðýmsýz öngördürücüsüydü.
Sonuç: Fiziksel aktivitenin prostat kanseri geliþimi veya agresifliði üzerindeki etkisi belirlenemedi. Fiziksel aktivite, radikal prostatektomiyi takiben üriner inkontinans riskinin azalmasýyla iliþkilendirildi. (SETB-2022-11-245)

Anahtar Kelimeler: Erektil disfonksiyon, PASE, fiziksel aktivite, prostat kanseri, üriner inkontinans

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