Comparison of outcome of total versus subcapsular orchidectomy in the management of patients with advanced carcinoma of the prostate

Abstract

Purpose: The majority of patients in our environment present with advanced prostate carcinoma, necessitating hormonal ablation. Total and subcapsular orchidectomies are standard methods of hormonal ablation. This study aimed to compare the postoperative reduction in the levels of testosterone, prostate size, and patient satisfaction after total or subcapsular orchidectomy.

Materials and methods: This was a prospective hospital-based study. A total of 61 patients with advanced prostate adenocarcinoma were recruited into this study and randomised into either the total or subcapsular orchidectomy group. Serum testosterone assay and prostate volume estimation were done pre- and postoperatively. Complication rates and patient satisfaction with the procedures were determined and compared. Patients were followed up for three months. Data analysis used the Statistical Package for Social Sciences (SPSS) version 22. Results were displayed using appropriate statistical methods. For all statistical tests, p < 0.05 was significant.

Results: In the third month, the mean serum testosterone level of patients in the subcapsular group was statistically higher than that of patients in the total orchidectomy group (p = 0.014). There was no significant difference in the percentage of prostate volume reduction between the two groups at intervals of one (p = 0.236) and three (p = 0.607) months. There was also no difference in complication rate and outcome satisfaction between the two groups.

Conclusion: The higher mean testosterone of patients at three months in the subcapsular orchidectomy group raises concern about the long-term efficacy of subcapsular orchidectomy. This underlines the need for long-term follow-up.