MP32-20 RECOVERY OF ERECTILE FUNCTION AFTER RADICAL PROSTATECTOMY: IDENTIFICATION OF TRAJECTORY CLUSTER GROUPS

Abstract

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Evaluation1 Apr 2014MP32-20 RECOVERY OF ERECTILE FUNCTION AFTER RADICAL PROSTATECTOMY: IDENTIFICATION OF TRAJECTORY CLUSTER GROUPS Catherine J. Harris, Christopher B. Anderson, Mary S. Dietrich, Daniel A. Barocas, Sam S. Chang, Michael S. Cookson, Joseph A. Smith, Peter E. Clark, S. Duke Herrell, and Melissa R. Kaufman Catherine J. HarrisCatherine J. Harris More articles by this author , Christopher B. AndersonChristopher B. Anderson More articles by this author , Mary S. DietrichMary S. Dietrich More articles by this author , Daniel A. BarocasDaniel A. Barocas More articles by this author , Sam S. ChangSam S. Chang More articles by this author , Michael S. CooksonMichael S. Cookson More articles by this author , Joseph A. SmithJoseph A. Smith More articles by this author , Peter E. ClarkPeter E. Clark More articles by this author , S. Duke HerrellS. Duke Herrell More articles by this author , and Melissa R. KaufmanMelissa R. Kaufman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.950AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Post-prostatectomy erectile dysfunction (ED) can impact health related quality of life in men treated with radical prostatectomy for prostate cancer. Predicting recovery patterns after prostatectomy can inform counseling pre-operatively and post-operative treatment. Using trajectory clustering analysis we identified predictors of post-prostatectomy erectile dysfunction and recovery patterns. METHODS In a five-year period health related quality of life was evaluated in patients treated with radical prostatectomy using UCLA-PCI pre-operatively, and 3, 6 and 12 months postoperatively. We used a novel cluster modeling technique to identify unique group trajectories of erectile function recovery with time. RESULTS Group based modeling of the UCLA-PCI sexual function scores identified 4 distinct post-prostatectomy erectile function recovery patterns. The 70 group 1 patients had significant ED at baseline and attained only 9.4% of optimum erectile function at 12 months. The 202 group 2 patients had a baseline UCLA-PCI sexual function score of 78.1 (IQR 65.6, 84.4) with 20.3% on treatment for ED and 7.4% impotent. Group 2 patients reached 18.9% of optimum erectile function at 12 months. The 88 group 3 patients had a baseline UCLA-PCI sexual function score of 84.4 (IQR 78.1, 90.6) with maximum loss of function at 3 months and a strong trend toward recovery at 12 months. Of these patients, 10.2% required ED treatment pre-operatively and 2.3% were impotent. The 43 group 4 patients maintained strong sexual function scores from baseline 87.4 (IQR 78.1, 93.8) to 12 months 78.1 (71.9, 84.4). Patients in groups 1 and 2 were older (p=0.009) and more likely to have ED requiring treatment (p=0.028) or to be impotent (p=0.01) at baseline than those in groups 3 or 4. On multivariate analysis, patients’ age and pre-operative erectile function significantly predicted inclusion in groups 1 or 2. Patients’ comorbidities, D’Amico risk group and degree of nerve sparing were not significant predictors of post-operative erectile function recovery. CONCLUSIONS A novel modeling approach identified 4 distinct post-prostatectomy erectile function recovery patterns. Patient age and pre-operative erectile function were most predictive of recovery patterns. These findings can assist in pre-operative counseling and post-prostatectomy interventions, such as identifying those that may benefit from penile rehabilitation programs. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e337-e338 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Catherine J. Harris More articles by this author Christopher B. Anderson More articles by this author Mary S. Dietrich More articles by this author Daniel A. Barocas More articles by this author Sam S. Chang More articles by this author Michael S. Cookson More articles by this author Joseph A. Smith More articles by this author Peter E. Clark More articles by this author S. Duke Herrell More articles by this author Melissa R. Kaufman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...