(207) Ejaculatory Function After Benign Prostatic Hyperplasia (BPH) in Gay and Bisexual Men

Abstract

Abstract Introduction Retrograde ejaculation (RE) is a common outcome of surgical treatments for benign prostatic hyperplasia (BPH). Previous qualitative work in the context of prostate cancer has shown that gay and bisexual men (GBM) experience greater bother from loss of ejaculatory function. Ideally, BPH treatment decision-making for GBM who prioritize ejaculatory function would take into consideration their specific needs and outcomes. However, there is no quantitative or prospective data on BPH outcomes in GBM men to inform their care. Objective Our objective was to analyze the characteristics of BPH patients in a urology clinic catered to the needs of GBM in order to fill the gaps in knowledge of BPH outcomes in GBM and improve care. Methods We performed a retrospective review of all GBM patients presenting to an LGBT specialized urology clinic between 9/1/2021 and 4/30/2023. Patients who underwent a procedure for BPH with at least one recorded AUA symptom score were included. Results 24 gay and bisexual BPH patients presenting to the clinic between 9/29/2021 and 4/25/2023 were included. Ages ranged from 32 to 82, with a mean age of 64.23 (SD = 11.43, n=24). The distribution of treatments offered was TURP (n=14), Rezum (n=4) and TUIP (n=1). Of the TURP procedures, 10 were ejaculatory sparing. Four patients received two forms of treatment. Of the 16 patients asked, 14 said ejaculatory sparing mattered to them (Mean age = 67.03, SD = 6.28) and 2 said it did not (Mean age = 77.63, SD = 10.57). The average pre-treatment AUA-Symptom Score for the patients was 20.85 (SD = 6.89, n=13) and average QoL was 4.00 (SD = 1.13, n=12). The average post-treatment AUA symptom score for patients was 8.50 (SD = 5.21, n=8), and average QoL was 1.38 (SD = 1.41, n=8). Conclusions A vast majority of the clinic’s GBM patients place importance on ejaculatory function. Younger GBM placed greater importance on ejaculatory function compared to older men. AUA symptom scores on average were on the low end of severe pre-treatment, with patients feeling mostly dissatisfied with urinary function. Post treatment AUA symptom scores varied but were centered around the low end of moderate, with patients feeling mostly pleased with urinary function. These initial findings from our clinic highlight the need for further prospective research on GBM patient values and outcomes surrounding ejaculatory function. Disclosure No.