Decline in bilateral orchiectomy for prostate cancer in Olmsted county, Minnesota, 1956-2000.
OBJECTIVE
To assess long-term secular trends in the utilization of bilateral compared with unilateral orchiectomy in the community.


METHODS
This population-based descriptive study reviewed medical records of all Olmsted County, Minnesota, men undergoing orchiectomy between 1956 and 2000.


RESULTS
Over the 45-year study period, 381 Olmsted County men had a first unilateral orchiectomy, while 431 underwent bilateral orchiectomy (including 8 with a second unilateral orchiectomy). There was no change over time in the age-adjusted utilization of unilateral orchiectomy, which was performed for a wide range of indications, mostly cryptorchidism and testicular malignancy. Most bilateral procedures, on the other hand, were in elderly men for castration, and trends over time generally paralleled those reported for prostate cancer in this community.


CONCLUSIONS
The declining incidence of prostate cancer in recent years, combined with a shift to earlier stages and younger ages at diagnosis, and the development of pharmacological approaches to hormonal manipulation have led to a dramatic decline in the utilization of bilateral orchiectomy, while unilateral orchiectomy rates have remained unchanged.
Melton
L J
LJ
Department of Health Sciences Research, Mayo Clinic, Rochester, Minn. 55902, USA.
Alothman
K I
KI
Achenbach
S J
SJ
O'Fallon
W M
WM
Zincke
H
H
D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D018672:Community Health Planning; D003456:Cryptorchidism / Q000453:epidemiology / Q000601:surgery; D019992:Databases as Topic; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009367:Neoplasm Staging; D009919:Orchiectomy / Q000706:statistics & numerical data* / Q000639:trends*; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000453:epidemiology / Q000601:surgery