MP36-08 PRE-PROCEDURAL LOW IIEF-5 AND TREATMENT OF PZ WITH ADJACENT NVB AND THE EJACULATORY DUCT WERE ASSOCIATED WITH SEXUAL DYSFUNCTION AFTER FOCAL THERAPY WITH HIGH-INTENSITY FOCUSED ULTRASOUND: A MULTI-INSTITUTIONAL PROSPECTIVE STUDY

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Medical, Hormonal & Non-surgical Therapy II (MP36)1 Sep 2021MP36-08 PRE-PROCEDURAL LOW IIEF-5 AND TREATMENT OF PZ WITH ADJACENT NVB AND THE EJACULATORY DUCT WERE ASSOCIATED WITH SEXUAL DYSFUNCTION AFTER FOCAL THERAPY WITH HIGH-INTENSITY FOCUSED ULTRASOUND: A MULTI-INSTITUTIONAL PROSPECTIVE STUDY Sunao Shoji, Satoshi Kuroda, Kazuma Takeda, Takato Uchida, Soichiro Yuzuriha, Izumi Hanada, Takahiro Ogawa, Mayura Nakano, Masayoshi Kawakami, Masahiro Nitta, Masanori Hasegawa, Yoshiaki Kawamura, and Akira Miyajima Sunao ShojiSunao Shoji More articles by this author , Satoshi KurodaSatoshi Kuroda More articles by this author , Kazuma TakedaKazuma Takeda More articles by this author , Takato UchidaTakato Uchida More articles by this author , Soichiro YuzurihaSoichiro Yuzuriha More articles by this author , Izumi HanadaIzumi Hanada More articles by this author , Takahiro OgawaTakahiro Ogawa More articles by this author , Mayura NakanoMayura Nakano More articles by this author , Masayoshi KawakamiMasayoshi Kawakami More articles by this author , Masahiro NittaMasahiro Nitta More articles by this author , Masanori HasegawaMasanori Hasegawa More articles by this author , Yoshiaki KawamuraYoshiaki Kawamura More articles by this author , and Akira MiyajimaAkira Miyajima More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002045.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We aimed to analyze clinical factors related to sexual function in patients with localized prostate cancer (PC) who were treated with focal therapy with high-intensity focused ultrasound (HIFU). METHODS: From 2016 to 2020, patients with localized PC who had erectile and ejaculatory function before focal therapy with HIFU, were included prospectively. Sexual function was evaluated for 12 months for each treated area. Before and after treatment, International Index of Erectile Function-5 (IIEF-5), sexual domain of the Expanded Prostate Cancer Index Composite (EPIC), and Common Terminology Criteria for Adverse Events (CTCAE) v.5.0 classification of ejaculation were used to assess sexual function. Erectile dysfunction (ED) and ejaculatory dysfunction (EjD) were defined as IIEF-5 score ≤7 and CTCAE grade 2. RESULTS: This study included 92 patients with median age 66 years, median IIEF-5: 16, and median sexual domain of EPIC: 55. Clinical T stages were T2a: n=54, T2b: n=17, and T2c: n=21. The rates of ED and EjD were 24% and 36%, respectively, at 12 months after treatment. Significant differences were observed between patients with preserved erectile function and those with ED in terms of clinical T stage (p=0.004), pre-procedural IIEF-5 (p=0.002), sexual domain of EPIC before treatment (p=0.011), and treatment of peripheral zone (PZ) with adjacent neurovascular bundle (NVB) (none vs. one side vs. both sides; p=0.017). In multivariate logistic regression analyses, pre-procedural score of 8-11 in IIEF-5 (OR 0.785; p=0.002) and treatment of PZ with adjacent NVB (OR 6.291; p=0.008) were significant risk factors for ED after treatment. Significant differences were observed between patients with preserved ejaculation and those with EjD in terms of pre-procedural IIEF-5 (p<0.0001), sexual domain of EPIC before treatment (p=0.002), and treatment of PZ with adjacent NVB (p=0.007) and ejaculatory duct (none vs. unilateral vs. bilateral; p<0.0001). In multivariate logistic regression analyses, pre-procedural score of 8-11 in IIEF-5 (OR 0.768; p<0.0001) and treatment range including the ejaculatory duct (OR 25.565; p=0.002) were significant risk factors for EjD after treatment. CONCLUSIONS: A greater risk of ED was associated with pre-procedural low IIEF-5 and treatment of PZ with adjacent NVB, and a greater risk of EjD was associated with pre-procedural low IIEF-5 and treatment of the ejaculatory duct after focal therapy with HIFU. Source of Funding: None. © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e638-e639 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sunao Shoji More articles by this author Satoshi Kuroda More articles by this author Kazuma Takeda More articles by this author Takato Uchida More articles by this author Soichiro Yuzuriha More articles by this author Izumi Hanada More articles by this author Takahiro Ogawa More articles by this author Mayura Nakano More articles by this author Masayoshi Kawakami More articles by this author Masahiro Nitta More articles by this author Masanori Hasegawa More articles by this author Yoshiaki Kawamura More articles by this author Akira Miyajima More articles by this author Expand All Advertisement Loading ...