PD30-06 RATES OF NEWLY DIAGNOSED ERECTILE DYSFUNCTION AFTER SURGERY FOR COLORECTAL CANCER

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Evaluation II (PD30)1 Sep 2021PD30-06 RATES OF NEWLY DIAGNOSED ERECTILE DYSFUNCTION AFTER SURGERY FOR COLORECTAL CANCER Christopher Gaffney, Nahid Punjani, Aaron Brant, Jonathan Fainberg, Xinyan Zheng, Art Sedrakyan, and James Kashanian Christopher GaffneyChristopher Gaffney More articles by this author , Nahid PunjaniNahid Punjani More articles by this author , Aaron BrantAaron Brant More articles by this author , Jonathan FainbergJonathan Fainberg More articles by this author , Xinyan ZhengXinyan Zheng More articles by this author , Art SedrakyanArt Sedrakyan More articles by this author , and James KashanianJames Kashanian More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002031.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Abdominoperineal resection (APR) and low anterior resection (LAR) for colorectal cancer (CRC) are associated with high rates of erectile dysfunction (ED) in case series that may be underdiagnosed in practice. We sought to explore rates of new diagnoses of ED after both minimally invasive (MIS) and open LAR, APR and hemicolectomy. METHODS: The Surveillance, Epidemiology, and End Results–Medicare database was used to record new diagnoses of ED after an index procedure (MIS or open LAR, APR or hemicolectomy) for CRC. The primary outcome was a new diagnosis of ED within 2 years of the index procedure. Men aged >66 years with any index procedure within 1 year of diagnosis of CRC were included. Men with a history of ED, metastatic CRC or prostate or bladder cancer prior to their index procedure were excluded. We performed a Cox proportional hazard model adjusting for baseline demographic factors, procedure group, procedure type (MIS versus open), Charlson comorbidity index, tumor stage and grade, history of chemoradiation therapy, and socioeconomic status through 2 years of follow up. RESULTS: Of 60, 648 men diagnosed with CRC between 2004-2015, 28,387 met inclusion criteria. 21,650 (76.4%) men were treated with hemicolectomy, 4,814 (17.0%) with LAR, and 1,883 (8.7%) with APR. On multivariable analysis, the hazard ratio (HR) for a new diagnosis of ED was 1.28 (95%CI 1.08 to 1.51) for LAR and 1.46 (95%CI 1.12-1.90) for APR compared to hemicolectomy. Other factors associated with a diagnosis of ED were black race (HR 2.01, 95%CI 1.63-2.48), geography (Southern compared to Northeast region) (HR 1.20 95%CI 1.08-1.57), and MIS (HR 1.43, 95%CI 1.25-1.65). Kaplan Meyer analysis detailing the increased rate of ED diagnoses in patients treated with APR and LAR as compared to hemicolectomy is seen in Figure 1. CONCLUSIONS: Compared to hemicolectomy, men treated with LAR and APR and men treated with MIS as compared to open surgery have higher rates of new ED diagnoses within 2 years of treatment. The absolute rate of ED diagnoses was low compared to prior carefully annotated case series, suggesting that patients are frequently underdiagnosed. Source of Funding: N/A © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e534-e534 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christopher Gaffney More articles by this author Nahid Punjani More articles by this author Aaron Brant More articles by this author Jonathan Fainberg More articles by this author Xinyan Zheng More articles by this author Art Sedrakyan More articles by this author James Kashanian More articles by this author Expand All Advertisement Loading ...