1533 COMPARISON OF RATES AND RISK FACTORS FOR DEVELOPMENT OF ERECTILE DYSFUNCTION AFTER RADICAL OR PARTIAL NEPHRECTOMY

Abstract

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Evaluation1 Apr 20111533 COMPARISON OF RATES AND RISK FACTORS FOR DEVELOPMENT OF ERECTILE DYSFUNCTION AFTER RADICAL OR PARTIAL NEPHRECTOMY Ryan Kopp, Jonathan Silberstein, Reza Mehrazin, Aditya Bagrodia, Robert Wake, Anthony Patterson, Jim Wan, and Ithaar Derweesh Ryan KoppRyan Kopp San Diego, CA More articles by this author , Jonathan SilbersteinJonathan Silberstein New York, NY More articles by this author , Reza MehrazinReza Mehrazin Memphis, TN More articles by this author , Aditya BagrodiaAditya Bagrodia Memphis, TN More articles by this author , Robert WakeRobert Wake Memphis, TN More articles by this author , Anthony PattersonAnthony Patterson Memphis, TN More articles by this author , Jim WanJim Wan Memphis, TN More articles by this author , and Ithaar DerweeshIthaar Derweesh San Diego, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1528AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Nephron Sparing Surgery (NSS) has emerged as a preferred treatment option for small renal masses, comparing favorably with radical nephrectomy (RN) from the standpoint of oncologic efficacy and conferring superior renal functional preservation. Erectile function may be affected by declining renal function. We examined the incidence of and risk factors for development of erectile dysfunction (ED) in patients who underwent RN and NSS. METHODS Retrospective review of 432 patients (264 RN/168 NSS, mean age 58 years, mean follow-up 5.8 years) who underwent RN or NSS for renal tumors at two institutions from 1/1998 to 12/2007. Demographics and disease characteristics, metabolic parameters [estimated Glomerular Filtration Rate (GFR), serum creatinine, hyperlipidemia, diabetes mellitus (DM)], pre- and postoperative ED (Sexual Health Inventory for Men score <22) and response rate to 5-phosphodiesterase inhibitor therapy (5-PDEi) were recorded in sexually active men. Data were analyzed within subgroups based on treatment (RN vs. NSS). Multivariate analysis (MVA) was conducted to elucidate risk factors for development of de novo ED. RESULTS RN and NSS groups had similar demographics and comorbidities. Tumor size (cm) was significantly larger for RN (RN 7.0 vs. NSS 3.7, p<0.001). No significant differences were observed for preoperative eGFR, hyperlipidemia, and DM. Significantly more preoperative ED existed in NSS vs. RN (p=0.042). Postoperatively, significantly higher rates of de novo DM (11.4% vs. 4.2%, p=0.015), eGFR<60 mL/min/1.73m2 (33.0% vs. 9.8%, p<0.001), and ED (29.5% vs. 9.5%, p<0.001) developed in RN vs. NSS cohorts, respectively. Overall response rate to 5-PDEi was 63% without significant difference between the two groups (p=0.896). MVA demonstrated RN (OR 3.56, p<0.001), hyperlipidemia (OR 2.32 p = 0.014), postoperative DM (OR 2.93, p<0.001), preoperative (OR 8.77, p<0.001) and postoperative (OR 2.64, p<0.001) eGFR <60mL/min/1.73m2 were significantly associated with de novo ED. CONCLUSIONS Patients undergoing RN had significantly higher de novo ED compared to a contemporary, well-matched cohort undergoing NSS. RN, DM, and eGFR<60 were associated with development of ED. Further investigation on effects of nephron loss on ED is requisite. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e615-e616 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ryan Kopp San Diego, CA More articles by this author Jonathan Silberstein New York, NY More articles by this author Reza Mehrazin Memphis, TN More articles by this author Aditya Bagrodia Memphis, TN More articles by this author Robert Wake Memphis, TN More articles by this author Anthony Patterson Memphis, TN More articles by this author Jim Wan Memphis, TN More articles by this author Ithaar Derweesh San Diego, CA More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...