(150) Erectile Dysfunction and Peyronie’s Disease Diagnosis Rates After Penile Fracture – A Retrospective Claims Database Cohort Analysis

Abstract

Abstract Introduction Penile fracture (PF) is a rare urologic emergency, with an estimated incidence of 500-600 PFs per year in the United States. Delays in surgical repair increase the risk of developing erectile dysfunction (ED) and Peyronie’s disease (PD). Objective Our objective was to analyze the rates of ED and PD following a PF using a large, multi-institutional claims database. Methods We conducted a cohort analysis utilizing the TriNetX Research database. The inclusion criteria included men ages 15 or older with a diagnosis of PF and any office visit within 5 years of the PF. Our exclusion criteria included any prior ED diagnosis, prescription of erectile aids, or penile prosthesis placement. Our primary outcome was the diagnosis of ED or prescription of erectile-aid dosing of phosphodiesterase-5 inhibitors (PDE5i) within five years. A secondary analysis was used to assess rates of PD following a PF. Subgroup analyses were performed for age and the impact of initial repair. Propensity-matching was performed to compare men with and without PF by calculating risk ratios (RR). Results 1,242 men were identified with a diagnosis of PF and subsequently matched to men without a PF, resulting in equal cohorts of 1,227 men. Men with a history of PF were more likely to receive a diagnosis of ED or require PDE5i (RR 3.18, 95% CI 2.30-4.40). Men over the age of 45 years who had a PF were more likely to develop ED or require ED treatment compared to men under 45 years (RR: 1.65, 95% CI 1.14-2.39). Men who did not undergo immediate repair had higher rates of ED diagnoses or treatment (RR: 1.84, 95% CI 1.22-2.78). Rates of PD diagnoses were significantly higher in men with a history of PF (5.8% vs 0%, p-value<0.0001). Rates of PD were significantly lower if immediate repair of the fracture was performed (RR: 0.20, 95% CI 0.10-0.41). Men over the age of 45 years with a history of a penile fracture were more likely to develop Peyronie’s Disease within 5 years compared to men under the age of 45 years with a history of penile fracture (RR: 3.73, 95% CI 1.94-7.16). Conclusions We found that a PF increases the risk of both ED and PD, especially for those treated with conservative measures or over the age of 45 years. Consequently, it is essential to follow up with these patients in the long term and survey potential adverse side effects relating to sexual function that may arise. Disclosure No.