109 Predictors of Rapid Disease Progression from Initial Diagnosis of Erectile Dysfunction to Surgical Intervention

Abstract

The prevalence of erectile dysfunction (ED) increases with age. Its association with metabolic syndrome, which poses a growing threat in the United States, has been well described. Urologists commonly follow a treatment algorithm involving phosphodiesterase type 5 inhibitors as first-line therapy, with escalation to other therapies and ultimately to penile prosthesis placement. While many are aware of risk factors for the development of ED, less is known about the comorbidities which may contribute to earlier surgical intervention. We aimed to look at trends in the treatment of men with ED from diagnosis to surgery, and clinical data associated with this progression. We used medical coding to query our database and identify men who underwent penile prosthesis implantation for ED from 2002 to 2017 within our regional health care system, excluding men with post-prostatectomy ED. We determined the date of initial ED diagnosis, and analyzed patient clinical data and associations with shorter time interval from diagnosis to surgical intervention using accelerated failure time models.