Affiliation:
1. Regional Clinical Hospital No. 2, Ministry of Health of Krasnodar Region; Kuban State Medical University
2. Kuban State Medical University
Abstract
Anxiety in men often increases during the rehabilitation period after prostate cancer surgery. Moreover, simultaneous development of erectile dysfunction is also observed. This contributes to psycho-emotional stress formation.
The aim of the study is to evaluate the effect of transcranial electrical stimulation (tES) on stress vulnerability during the rehabilitation period after various types of prostate cancer surgery.
Materials and Methods. The authors estimated anxiety level and erectile dysfunction in 124 men 6 months after prostate cancer surgery. The patients were divided into groups according to the surgery type: Group 1 (n=24) – high-intensity focused ultrasound (HIFU); Group 2 (n=50) – laparoscopic radical prostatectomy; Group 3 (n=50) – laparotomic radical prostatectomy. Serum concentration of adrenocorticotropic hormone (ACTH), cortisol, adrenaline, interleukins 1 and interleukins 2 (IL-1, IL-2) and stress vulnerability level according to N.V. Kirsheva and N.V. Ryabchikova test, Holmes and Rahe stress scale, S. Cohen and G. Williamson test, and “Prognosis” method was determined twice: before and after tES.
Results. Erectile dysfunction was detected in 37 patients 6 months after radical prostatectomy (Group 2, n=17; Group 3, n=20). All the patients of Group 1 (HIFU) restored erection. A decrease in stress vulnerability was observed in all patients, regardless of the surgery type and the severity of functional disorders. After tES, a significant decrease in the levels of ACTH, cortisol, IL-1, IL-2 was estimated (p<0.05). According to all tests used, a significant increase in stress vulnerability was noted, regardless of the type of surgery (p<0.001).
Conclusion. In terms of frequency of functional disorder development during the rehabilitation period, HIFU has advantages over radical prostatectomy, regardless of the surgical approach. Transcranial electrical stimulation 6 months after surgery significantly reduces the level of stress hormones and interleukins in patients’ blood serum; increases stress vulnerability regardless of the surgery type and functional disorders. Moreover, tES can be recommended for all patients after prostate cancer surgery.
Publisher
Ulyanovsk State University
Reference31 articles.
1. Davis M., Peters T.J., Turner E.L., Martin R.M., Oxley J., Path F.R.C., Robinson M. 10-year outcomes after monitoring, surgery, or radiotherapy for localized prostate cancer. N. Engl. J. Med. 2016; 375: 1415–1424.
2. Valerio M., Cerantola Y., Eggener S.E., Lepor H., Polascik T.J., Villers A., Emberton M. New and established technology in focal ablation of the prostate: a systematic review. Eur. Urol. 2017; 71: 17–34.
3. Daniele Castellani, Alessandro Branchi, Redi Claudini, Luca Gasparr, Tiziana Pierangel Elena Ravasi, Marco Dellabella. A structured framework for optimizing high-intensity focused ultrasound ablative treatment in localized prostate cancer. Investig. Clin. Urol. 2019; 60 (4): 312–318.
4. Guillaumier S., Peters M., Arya M., Afzal N., Charman S., Dudderidge T. A multicentre study of 5-year outcomes following focal therapy in treating clinically significant nonmetastatic prostate cancer. Eur. Urol. 2018; 74: 422–429.
5. Penzhoyan G.A., Markova L.M., Grishanov N.V. Znachenie etiologicheskikh faktorov narusheniya reproduktivnoy sistemy muzhchin v lechenii muzhskogo besplodiya [Significance of etiological factors of male reproductive system disorders in male infertility treatment]. Problemy reproduktsii. 2000; 6 (6): 60–61 (in Russian).