(049) Prevalence of Erectile Dysfunction in Men with Stress Urinary Incontinence After Radical Prostatectomy

Abstract

Abstract Introduction Stress urinary incontinence (SUI) and erectile dysfunction (ED) are significant complications that have a negative impact on patients' quality of life following radical prostatectomy (RP). Objective This study aimed to assess the prevalence of ED in men with SUI who underwent RP the first year after RP. Methods This study included men who underwent RP and followed up for 1 year post-surgery. Men who received androgen deprivation therapy (ADT) or radiation therapy before or after RP were excluded. We performed a descriptive assessment of demographics, comorbidities, erectile function (EF), laboratory, surgical pathology, and nerve-sparing status (NSS). Post-op SUI was described based on the number of pads used per day, categorized as 0 to 1 pad per day (continent or mild/social SUI), 2 pads per day (moderate SUI), and ≥ 3 pads per day (severe SUI) at 3, 6, and 12 months post-RP. ED was described based on IIEF score as normal EF normal (≥24), mild ED (18-23), moderate ED (11-17), and severe ED (≤10) at 3, 6, and 12 months post-RP. We reported the prevalence of ED among men with SUI during the first year after RP. We assessed if the severity of the SUI was a predictor of severe ED in a multivariable logistic regression model at 3, 6, and 12 months post-RP. Factors entered into the model included: patient age, number of comorbidities (≥ 3), NVB status (both resected), pre-RP EF, PDE5i exposure post-RP (yes), and severe SUI (≥ 3 pads per day). Results 9953 men were included in this study, with a median age of 62 (56, 67). The median number of comorbidities was 1 (0, 2). 10% had diabetes, 27% obstructive sleep apnea, and 19% reported 3 or more comorbidities. Preoperative median PSA was 5.7 ng/ml, with a median Gleason grade of 2 (2, 3).73% had Bilateral NSS, 20% unilateral, and 7% had both sides resected. The prevalence of severe ED was higher among men with severe SUI compared to men with 0 to 1 pad per day at 3, 6, and 12 months post-RP. At 3 months, men with 0 to 1 pad per day reported 31% no/mild ED and 59% severe ED, vs. men with severe SUI described 18% no/mild ED and 75% severe ED (p-value <0.001). At 6 months, for men with continence/mild SUI, 35% described no/mild Ed and 51% severe ED vs. men with severe SUI who had 20% no/mild ED and 70% severe ED (p-value <0.001). And at 12 months, men with 0 to 1 pad per day reported 42% no/mild ED and 46% severe ED, vs. men with severe SUI described 22% no/mild ED and 70% severe ED (p-value <0.001). In the multivariable regression model, severe SUI significantly predicted severe ED at 3, 6, and 12 months (Table1). Conclusions Men experiencing severe SUI have a high prevalence of severe erectile dysfunction. Severe SUI significantly predicted severe ED during the first year following RP. Disclosure No.