title: Impact of radical prostatectomy and TURP on the hypothalamic-pituitary-gonadal hormone axis.
abstract: OBJECTIVE
  To assess the impact of prostate cancer (PCa) and benign prostatic hyperplasia (BPH) on the hypothalamic-pituitary hormone axis, we determined the endocrine changes after radical prostatectomy (RP) and transurethral resection of the prostate (TURP) for BPH and in a group of men with BPH followed up conservatively.
  
  
  METHODS
  Patients with PCa before RP (n = 49), those who underwent TURP for BPH (n = 51), and men with lower urinary tract symptoms for whom a wait-and-see strategy was chosen (n = 46) were included. Serum levels of total testosterone, luteinizing hormone, and follicle-stimulating hormone were determined at baseline and 6 and 12 months later in all patients.
  
  
  RESULTS
  No significant endocrine changes were observed in the wait-and-see and TURP groups 6 and 12 months after baseline. In contrast, luteinizing hormone increased from 5.2 to 8.9 mIU/mL (P = 0.0004) and follicle-stimulating hormone from 5.7 to 9.3 mIU/mL (P = 0.0003) 12 months after RP. The rise of total testosterone from 3.9 to 4.4 ng/mL failed to reach statistical significance (P = 0.18). Patients with Gleason score 2 to 6 PCa had higher testosterone values (4.2 ng/mL) at baseline than did those with Gleason score 7 to 10 PCa (2.2 ng/mL, P < 0.05). Although 12 months after RP no changes in testosterone were observed in the low Gleason score group, the testosterone levels more than doubled in those with high-grade tumors. The increases in luteinizing hormone and follicle-stimulating hormone at 12 months, however, were comparable in both groups.
  
  
  CONCLUSIONS
  Our findings suggest a significant impact of PCa on the hypothalamic-pituitary axis that is more profound in high-grade cancer. Such an effect was not demonstrable for the transition zone in BPH.
authors.affiliation: Department of Urology, University of Vienna, Vienna, Austria.
authors.forename: Stephan
authors.initials: S
authors.lastname: Madersbacher
authors.forename: Georg
authors.initials: G
authors.lastname: Schatzl
authors.forename: Christian
authors.initials: C
authors.lastname: Bieglmayer
authors.forename: Werner J
authors.initials: WJ
authors.lastname: Reiter
authors.forename: Christa
authors.initials: C
authors.lastname: Gassner
authors.forename: Peter
authors.initials: P
authors.lastname: Berger
authors.forename: Thomas
authors.initials: T
authors.lastname: Zidek
authors.forename: Michael
authors.initials: M
authors.lastname: Marberger
mesh_terms: D000368:Aged; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology*; D007986:Luteinizing Hormone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000097:blood / Q000601:surgery*; D011471:Prostatic Neoplasms / Q000097:blood / Q000601:surgery*; D012016:Reference Values; D013739:Testosterone / Q000097:blood*
chemical_list: D013739:Testosterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone