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The association of smoking with urinary and sexual function recovery following radical prostatectomy for localized prostate cancer: a systematic review and meta-analysis
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The association of smoking with urinary and sexual function recovery following radical prostatectomy for localized prostate cancer: a systematic review and meta-analysis
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The association of smoking with urinary and sexual function recovery following radical prostatectomy for localized prostate cancer: a systematic review and meta-analysis
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Journal Article
The association of smoking with urinary and sexual function recovery following radical prostatectomy for localized prostate cancer: a systematic review and meta-analysis
2024
Overview
Background
Urinary and sexual dysfunction after radical prostatectomy remains a major cause of morbidity, despite widespread availability of pharmacological and rehabilitative treatments. Smoking is a modifiable risk factor known to correlate with erectile and urinary dysfunction and we hypothesise that smoking cessation may improve post-prostatectomy urinary and sexual function recovery. Our objective is to systematically evaluate literature describing the association of smoking status with urinary and sexual function in men following radical prostatectomy.
Methods
In total, 310 unique records were identified through a systematic search of the MEDLINE, EMBASE, Scopus, Web of Science, CINAHL and CENTRAL databases up to February 2023. Nine studies reported smoking status and post radical prostatectomy urinary and sexual function outcomes in men with localized prostate cancer. Risk of bias was assessed and meta-analysis included six studies.
Results
Smokers had inferior erectile function after prostatectomy compared to non-smokers (OR 0.73, [95% CI 0.56–0.95]) during follow-up, while urinary incontinence was not statistically different between groups (OR 1.20, [95% CI 0.75–1.91]). Smoking cessation improved the EPIC-26 sexual domain score with 6.6 points on average [
p
= 0.03] to a clinically significant maximum of 12.5 points at 18–24 months.
Conclusions
Smoking is associated with impaired sexual function recovery after radical prostatectomy and quitting may improve sexual function >18 months. Current evidence shows no such association for urinary outcomes. Further studies are needed to corroborate findings.
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
/ Biomedical and Life Sciences
/ Erectile Dysfunction - epidemiology
/ Erectile Dysfunction - etiology
/ Humans
/ Male
/ Postoperative Complications - epidemiology
/ Postoperative Complications - etiology
/ Prostatectomy - adverse effects
/ Prostatic Neoplasms - surgery
/ Recovery
/ Sexual Dysfunction, Physiological - epidemiology
/ Sexual Dysfunction, Physiological - etiology
/ Smoking
