PD31-06 MENTAL HEALTH ILLNESS AFTER EXTERNAL GENITOURINARY TRAUMA: A CASE-CONTROL STUDY IN A US POPULATION

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: External Genitalia Reconstruction and Urotrauma (including transgender surgery) II (PD31)1 Sep 2021PD31-06 MENTAL HEALTH ILLNESS AFTER EXTERNAL GENITOURINARY TRAUMA: A CASE-CONTROL STUDY IN A US POPULATION Christopher J Loftus, Alexander Skokan, Sarah Holt, and Judith C Hagedorn Christopher J LoftusChristopher J Loftus More articles by this author , Alexander SkokanAlexander Skokan More articles by this author , Sarah HoltSarah Holt More articles by this author , and Judith C HagedornJudith C Hagedorn More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002032.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Patients who sustain traumatic injuries are at risk for developing post-traumatic stress and mental health disease. Due to the nature of the injuries, trauma that affects the penis, testicles and scrotum may place men at an even greater risk for these psychological sequelae. The objective of this study was to characterize the development of mental health illness in men experiencing external genitourinary (GU) trauma in a national cohort. METHODS: We performed a case-control study using Truven MarketScan, a national employer-based insurance claims database, from 2007 to 2019. Male patients at least 18 years of age who sustained external GU injury involving the penis, scrotum and/or testicles were identified by ICD-9/10 codes. We excluded men with a history of depression, anxiety or erectile dysfunction (ED) in the year before injury, those with pelvic fractures at time of injury, and those with <24months of continuous follow-up after their injury. Control patients were defined as men with isolated traumatic injuries of the upper extremity (UE). The primary outcome of interest was a new claim with an ICD-9/10 diagnostic code for either depression or anxiety which acted as a surrogate marker for mental health illness. Logistic regression was used to adjust for age and calculate adjusted odds ratios. RESULTS: We identified 4,026 men who sustained external GU trauma and 102,045 men with UE trauma. Men with GU injuries had a median age of 40 years (IQR 26-51) and were younger than men with UE injuries (40 vs. 43 years, p<.001). Men with GU injuries had a higher rate of developing depression/anxiety (11.6% vs. 10.3%, OR 1.2 [1.04-1.27], p=.007). Of men with GU injuries, 7.1% developed new ED as compared to 3.6% with UE injuries (OR 2.4 [2.07-2.67], p<.0001). While ED was positively correlated with new depression/anxiety in all men (p<.0001), GU injury was associated with mental health illness independently of the additional diagnosis of ED (p<.0001). Of men with GU injuries, 2.2% developed Peyronie’s disease as compared to 0.1% with UE injuries (OR 20.8 [15.8-27.5], p<.0001). CONCLUSIONS: Even within intermediate-term follow-up, men who sustain external GU traumatic injury have high rates of developing new depression and anxiety and this rate is higher than in those sustaining an isolated orthopedic injury. These data support that counseling these patients about mental health should be considered at the time of injury and that subsequent signs of psychological distress and ED should be monitored closely in follow-up. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e540-e540 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christopher J Loftus More articles by this author Alexander Skokan More articles by this author Sarah Holt More articles by this author Judith C Hagedorn More articles by this author Expand All Advertisement Loading ...