Agarwal and Agarwal [21] demonstrated equivalent PSA and testosterone declines in patients who had BSO, BSCO, or BESO while some other studies have shown therapeutic equivalence between BSO and BSCO, [14, 20, 31] or BSO and BESO [32], thus buttressing the fact that the pursuit of cosmetic appeal did not take precedence over effective PCa therapy. This evidence concerns the gene KLK3 and posterior cortical atrophy.