MP51-18 ONE OUT OF TEN PATIENTS SUBMITTED TO RADICAL PROSTATECTOMY COMPLAINS OF POSTOPERATIVE PAINFUL ORGASM

Abstract

testosterone (T) in male cardiology patients. Here we sought to assess the relationships of calculated free testosterone (CFT) with ejaculatory function and overall sexual satisfaction. METHODS: We assessed a cohort of 200 consecutive men within a cardiology clinic via IIEF 15, IPSS, ADAM, and previous ED treatment questionnaires, serum total testosterone (T), estradiol (E), and sex hormone binding globulin (SHBG). Data were collected on patient age, BMI, cardiac history and comorbidities. We performed Spearman correlations to explore the association between CFT and ejaculatory function, ability to orgasm, and overall sexual satisfaction. Next, we performed logistic regression models to predict those same sexual outcomes with low CFT adjusting for diabetes, stroke, age, BMI, smoking, HTN, CABG, cardiac stents, beta blockers, antidepressants, alpha blockers, IPSS, and IIEF6 total score. A CFT of 6.5 or greater was considered normal. RESULTS: 200 patients were included in the study (mean age 67). Mean CFT was 5.4ng/dl. Prevalence of low CFT was 79% while low total T was only 55%. 34% of men ejaculated half the time or less with sexual stimulation. 46% of men had an orgasm half the time or less with sexual stimulation and 30% reported that they almost never or never experienced orgasm. 46% of men reported being dissatisfied and 32% very dissatisfied with their overall sex life. As CFT decreased, the rate of overall ejaculatory dysfunction increased significantly (p1⁄40.0023) (r21⁄4-0.22). There were positive correlations (r21⁄40.20, r21⁄40.173) between CFT and ability to orgasm (p1⁄40.0044) and ability to ejaculate (p1⁄40.0552). CFT was also significantly correlated with overall sex life satisfaction (p1⁄40.0305) (r1⁄40.16). After adjusting for covariates using stepwise logistic regression, ejaculatory dysfunction was predicted only by IIEF6 total score (r2 1⁄4 0.024;p 0.0034), CABG (p1⁄40.0284), and antidepressant use (p1⁄40.0057). Using the same model, ability to orgasm was predicted by age (r2 1⁄4 0.38, p 1⁄4 0.024) and IIEF 6 (p< 0.0001). Similarly, overall sexual satisfaction was predicted by age (r21⁄40.35, p1⁄40.0229) and IIEF 6 (p <.0001). CONCLUSIONS: Hypogonadism was associated with an increased risk of ejaculatory dysfunction, decreased ability to orgasm, and decreased sex life satisfaction. However, after adjusting for all variables, CFT did not predict ejaculatory dysfunction, ability to orgasm, or overall sexual satisfaction.