IIEF-erectile Function Domain Research Articles

(018) Predictors of the Conduct of Nerve Sparing During Radical Prostatectomy

Abstract Introduction The association between nerve-sparing (NS) status at the time of radical prostatectomy (RP) and functional outcomes is well described; however, our profession lacks insight as to whether patient factors such as age and baseline erectile function influence surgeon behavior when it comes to nerve-sparing during RP. Objective We analyzed predictors associated with bilateral nerve damage/resection at the time of RP. Methods The study included patients who underwent RP with surgeon-reported NS scoring. The NS outcome of the right and left sides were independently scored between 1-4: 1 = completely preserved, 2 = partially preserved, 3 = partially damaged, and 4 = completely resected; scores of 1 or 2 indicate nerve-sparing and scores of 3 or 4 indicate non-nerve-sparing. We classified overall NS status as bilateral, unilateral, or not-spared. Demographics, ED-related comorbidities, pre-RP digital rectal exam (DRE), most recent prostate biopsy (bx) results, and pre-RP IIEF Erectile Function Domain (EFD) were analyzed. Pre-RP prostate MRI was used to define prostate volume (PV). EFD score < 24 defined non-functional erections. We created a multivariable (MV) model to define predictors of poorer NS status. The model included patient age, pre-RP EFD, PV, PSA, DRE, noted possible extracapsular extension (ECE) on pre-RP MRI, number of positive bx cores, and predominant Gleason (G) score on bx. Results 3805 men met inclusion criteria. Median age was 64 (57, 67) years. Median pre-RP EFD score was 26 (15, 30); 41% had a pre-RP EFD score < 24. Median PV and PSA were 35 (27, 47) mL and 5.7 (4.2, 8.4) ng/dL, respectively. 64% had a normal pre-RP DRE. Median total bx cores 12 (9, 14). Median positive bx cores 4 (2, 7). Distribution of bx pathology: 17% G6, 64% G7, 10% G8, 8% G9, <1% G10. 65% had predominant G3 and 34% G4 pathology. 26% of MRI reports noted some degree of suspicion for ECE. NS status at RP: bilateral (69%), unilateral (20%), non-spared (11%). Median NS score was 3 (2, 4). On MV analysis, abnormal DRE, number of positive bx cores, and predominance of G4 were predictive of non-NS surgery. Most notably, the non-oncological factors – older patient age and a pre-RP EFD < 24 – were also predictive of non-NS surgery (Table). Conclusions While patient age and baseline erectile function (EF) are not necessarily predictors of a patient’s interest in preserving EF, these non-oncologic factors were identified as predictors of non-NS surgery in this analysis. Surgeons should define the individual patient’s sexual function goals prior to RP. Disclosure No.

(155) Peyronie's Disease in Young Adults: Symptomatic Burden and Clinical Characteristics

Abstract Introduction Peyronie's disease is a common yet poorly understood condition occurring in teenagers as well as in men in their late 70s. Objective The aim of the study is to investigate whether patients’ age has an impact in terms of Peyronie’s disease (PD) clinical characteristics at presentation. Methods Data from a group of 125 consecutive patients aged >18 and with PD and seeking first medical attention at a single andrological tertiary-referral centre, with a complete clinical assessment and who completed the IIEF-15 and PDQ questionnaires were included in the study. Descriptive statistics was used to compare categorical and continuous variables, between young (≤45 years) and old (>45 years) patients at presentation. Linear and logistic regression analyses tested the association between age and PDQ subscales (Pain, Bother and Symptoms) or IIEF-erectile function domain scores (IIEF-EF ≤26), after adjusting for Charlson Comorbidity Index (CCI), Body Mass Index (BMI), duration of PD (as self-reported by the patient), smoking habit and penile curvature. LOWESS curve was used to graphically investigate the association between age and PDQ pain score. Results Of 125, 33 (26%) patients were ≤45 years old. Young patients had lower BMI [median (IQR) 23.6 (21.4-25.1) vs. 25.5 (23.7-27.8); p=0.01] and CCI [CCI≥1 in 1 patient (3%) vs. 25 (27%); p=0.007) compared to older patients. No differences were found between groups in terms of PD duration and plaque size, however curvature was lower among younger patients (20° [15-50] vs 47 [40-75]; p=0.045). PDQ pain score was 6 (2.0-10.0) for younger and 3 (0-8) for older patients (p=0.049). No differences were found in terms of PDQ-symptoms and bother scores, and for IIEF domain scores. At multivariable regression analysis, younger age was associated with significant higher PDQ-pain scores at presentation (Coeff 4.39; 95%CI 2.64:6.16; p<0.011). No further associations were observed between age and the other questionnaires. The figure depicts the higher PDQ-pain scores in young compared to older age. Conclusions Younger PD patients are at higher risk of complaining penile pain at presentation despite having a lower penile curvature. No difference in terms of symptoms, PD-associated bother, erectile function and other clinical and morphometric characteristics were found between younger and older patients at first assessment. Disclosure No

MP45-09 CANCER SURVIVORSHIP IN MALE PATIENTS: THE IMPORTANCE OF INVOLVING THE ANDROLOGIST IN THE REAL-LIFE WORLD

You have accessJournal of UrologyCME1 Apr 2023MP45-09 CANCER SURVIVORSHIP IN MALE PATIENTS: THE IMPORTANCE OF INVOLVING THE ANDROLOGIST IN THE REAL-LIFE WORLD Simone Cilio, Edoardo Pozzi, Federico Belladelli, Giuseppe Fallara, Luigi Candela, Alessandro Bertini, Christian Corsini, Francesco Lanzaro, Donato Cannoletta, Massimiliano Raffo, Fausto Negri, Ludovica Cella, Margherita Fantin, Luca Boeri, Paolo Capogrosso, Alessia D'arma, Francesco Montorsi, and Andrea Salonia Simone CilioSimone Cilio More articles by this author , Edoardo PozziEdoardo Pozzi More articles by this author , Federico BelladelliFederico Belladelli More articles by this author , Giuseppe FallaraGiuseppe Fallara More articles by this author , Luigi CandelaLuigi Candela More articles by this author , Alessandro BertiniAlessandro Bertini More articles by this author , Christian CorsiniChristian Corsini More articles by this author , Francesco LanzaroFrancesco Lanzaro More articles by this author , Donato CannolettaDonato Cannoletta More articles by this author , Massimiliano RaffoMassimiliano Raffo More articles by this author , Fausto NegriFausto Negri More articles by this author , Ludovica CellaLudovica Cella More articles by this author , Margherita FantinMargherita Fantin More articles by this author , Luca BoeriLuca Boeri More articles by this author , Paolo CapogrossoPaolo Capogrosso More articles by this author , Alessia D'armaAlessia D'arma More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Andrea SaloniaAndrea Salonia More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003291.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Male cancer survivors may develop sexual dysfunction (SD) even many years after the recovery from the original malignant disease. An andrological assessment of these patients is not routinely provided in the everyday clinical practice. We aimed to evaluate the prevalence of and the clinical characteristics of cancer survivors in a cohort of men seeking medical help for SD (any) in the real-life setting of an andrological tertiary-referral centre. METHODS: Complete data from 2841 men consecutively assessed for new-onset SD between 2005 and 2022 were analysed. All patients were assessed with a comprehensive sexual and medical history, including history of any non-metastatic cancer (i.e., urological cancers, non-urological solid cancers, haematological cancer). All patients were invited to complete the International Index of Erectile Function (IIEF), and the Beck’s Depression Index (BDI). The IIEF-Erectile function (IIEF-EF) domain was categorized according to Cappelleri’s criteria. RESULTS: Of all, 237 (8.34%) patients reported a history of non-metastatic cancer, either solid or haematological. Of 237, 118 (49.8%) patients had a history of urological cancer, 92 (38.8%) of non-urological solid cancer, and 27 (11.4%) of haematological malignancies. Overall, the most frequent complaint was ED (76.4% of patients), followed by Peyronie’s disease (PD) (13.9%), low sexual desire/interest (LSD/I) (13.5%), premature ejaculation (PE) (6.8%), and delayed ejaculation (2.1%). Moreover, the most frequent concurrent complaints were ED and LSD/I reported together by 11.4% of patients, followed by ED and PD reported by 8.4% of patients. Of all, prostate cancer (PCa) survivors accounted for 41.0% of solid cancer survivors and 37.1% of the whole cohort. The most frequent non-urological cancer was colorectal cancer (CRC), reported by 10.6% of patients. Men with a history of either PCa or CRC complained more of ED [98 (92.5%) vs .68 (62.4%) men; p=0.001] and had lower rates of normal IIEF-EF [1 (0.9%) vs. 6 (5.5%) men; p=0.03], with respect to patients with a history of other types of cancers, whom conversely reported higher rates of PE [4 (3.8%) vs. 12 (11%) men; p=0.03] and of PD [9 (8.5%) vs. 21 (19.3%) men; p=0.007]. CONCLUSIONS: Almost 10% of men seeking first medical help for SD in a tertiary-referral andrology centre are cancer survivors. Following the improvement of survivorship rates in male patients, an andrological assessment should always be included throughout the follow-up of cancer survivors. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e624 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Simone Cilio More articles by this author Edoardo Pozzi More articles by this author Federico Belladelli More articles by this author Giuseppe Fallara More articles by this author Luigi Candela More articles by this author Alessandro Bertini More articles by this author Christian Corsini More articles by this author Francesco Lanzaro More articles by this author Donato Cannoletta More articles by this author Massimiliano Raffo More articles by this author Fausto Negri More articles by this author Ludovica Cella More articles by this author Margherita Fantin More articles by this author Luca Boeri More articles by this author Paolo Capogrosso More articles by this author Alessia D'arma More articles by this author Francesco Montorsi More articles by this author Andrea Salonia More articles by this author Expand All Advertisement PDF downloadLoading ...

Prevalence and predictors of unrecognised low sexual desire/interest in men with new onset erectile dysfunction: findings from a cross-sectional, real-life study.

The interrelationship between male sexual desire and erectile dysfunction (ED) has been scantly investigated. Thus, we aimed at investigating the prevalence of and the predictors of unrecognised low sexual desire/interest (uLSD/I) in a cohort of men with new onset ED. Complete data from 1587 men seeking for first medical help for ED between 2010 and 2021 were analysed. Comorbidities were scored with the Charlson Comorbidity Index (CCI). At entrance, all patients were asked to self-report low sexual desire/interest and completed the International Index of Erectile Function (IIEF) and the Beck Depression Inventory (BDI) (depressive symptoms scored as BDI ≥ 11). The IIEF-erectile function (IIEF-EF) domain was categorised according to Cappelleri's criteria. The median value of the IIEF-sexual desire domain (IIEF-SD) was used to dichotomise men with uLSD/I along with ED (IIEF-SD < 7) vs. ED-only (IIEF-SD ≥ 7). Circulating hormones were measured in every patient. Hypogonadism was defined as total testosterone (tT) <3.0 ng/mL. Descriptive statistics and logistic regression models tested the association between clinical variables and uLSD/I. Of 1197 patients not self-reporting LSD/I, 369 (30.8%) had IIEF-SD < 7. Patients with ED + uLSD/I were older [median (IQR) 54(41-63) vs. 49(36-59) years], had lower IIEF-EF [10.5(5-22) vs. 22(11-28)] but higher BDI [6(3-12) vs. 4(1-8)] and lower tT [4.3(3.2-5.7) vs. 4.8(3.2-6.3) ng/mL] compared to ED-only men (all p < 0.05). Overall, ED + uLSD/I men had higher rate of severe ED (49.9% vs. 23.9%), and of BDI ≥ 11 (30.6% vs. 18.2%) (all p < 0.05). At multivariable logistic regression analysis, lower tT (OR: 0.82), lower IIEF-EF scores (OR:0.95) and BDI ≥ 11 (OR:2.51) were independently associated with ED + uLSD/I, after accounting for age (all p < 0.05). Almost 30% of men seeking first medical help for ED-only had also uLSD/I. Men with both conditions were older, had higher rates of severe ED and more depressive symptoms. A detailed investigation of sexual desire should be always included in men self-complaining only of ED.

The symptomatic burden of Peyronie's disease at presentation according to patient age: A critical analysis of the Peyronie's disease questionnaire (PDQ) domains.

Peyronie's disease (PD) has a huge impact on patients' physical and psychological wellbeing. To investigate whether patients' age has an impact on PD symptomatic burden at first presentation. Data from 129 consecutive heterosexual patients seeking first medical attention for PD at a single andrological tertiary-referral centre were collected. All patients completed the International Index for Erectile Function (IIEF) and the PD questionnaire (PDQ). Descriptive statistics were used to compare clinical features between younger (≤40years) and older (>40 years) patients. Multivariable linear model assessed the impact of age, the degree of penile curvature and their impact on PDQ (total scores and its domains), after adjusting for PD duration and IIEF-erectile function domain scores. Of 129, 24 (18.6%) patients were ≤40 years old. Young patients presented with a less severe curvature than older patients (median [interquartile ranges] 20° [15-36] vs. 50° [40-80]; p=0.04). However, younger age was associated with higher psychological and physical symptoms, PDQ-penile pain and PDQ-symptom bother scores (Coeff -0.11, -0.21 and -0.17, respectively) (all p<0.05). Moreover, the greater the degree of curvature, the higher the PDQ-psychological and physical symptoms and the PDQ-symptom bother scores (Coeff. 0.21 and 0.22, respectively; all p<0.05). Around one in five men seeking first medical help for PD is younger than 40 years at presentation in the real-life setting. PD-related distress varies according to patients' age, with younger men presenting with a greater risk of penile pain and symptom bother despite lower curvature.

Peyronie's disease in young adults: symptomatic burden and clinical characteristics

<h3>Objectives</h3> To investigate whether patients' age has an impact in terms of Peyronie's disease (PD) clinical characteristics at presentation. <h3>Methods</h3> Data from a group of 110 consecutive patients aged >18 and <70 years with PD and seeking first andrological attention, with a complete clinical assessment and who completed the IIEF-15 and PDQ questionnaires were included in the study. Descriptive statistics was used to compare categorical and continuous variables, between young (≤45 years) and old (>45 years) patients at presentation. Linear and logistic regression analyses tested the association between age and PDQ subscales (Pain, Bother and Symptoms) or IIEF-erectile function domain scores (IIEF-EF ≤26), after adjusting for Charlson Comorbidity Index (CCI), Body Mass Index (BMI), duration of PD (as self-reported by the patient) and smoking habit. LOWESS curve was used to graphically investigate the association between age and PDQ pain score. <h3>Results</h3> Of 110, 28 (25%) patients were ≤45 years old. Young patients had lower BMI [median (IQR) 24.3 (22.5-25.6) vs. 25.2 (23.7-27.8); p=0.01] and CCI [CCI≥1 in 1 patient (3.6%) vs. 23 (28%); p=0.014) compared to older patients. No differences were found between groups in terms of severity of the penile curvature, PD duration and plaque size. PDQ pain score was 6 (2.8-12.8) for young and 3 (0-8) for older patients (p=0.03). No differences were found in terms of PDQ-symptoms and bother scores, and for IIEF domain scores. At regression analysis, younger age was associated with significant higher PDQ-pain scores at presentation (Coeff 4.45; 95%CI 1.06:7.84; p=0.011). No further associations were observed between age and the other questionnaires. <h3>Conclusions</h3> Younger PD patients are at higher risk of complaining penile pain at presentation. No difference in terms of symptoms, PD-associated bother, erectile function and other clinical and morphometric characteristics were found between younger and older patients at first assessment <h3>Conflicts of Interest</h3> None

Peyronie's disease in young adults: symptomatic burden and clinical characteristics

To investigate whether patients’ age has an impact in terms of Peyronie's disease (PD) clinical characteristics at presentation. Data from a group of 110 consecutive patients aged >18 and <70 years with PD and seeking first andrological attention, with a complete clinical assessment and who completed the IIEF-15 and PDQ questionnaires were included in the study. Descriptive statistics was used to compare categorical and continuous variables, between young (≤45 years) and old (>45 years) patients at presentation. Linear and logistic regression analyses tested the association between age and PDQ subscales (Pain, Bother and Symptoms) or IIEF-erectile function domain scores (IIEF-EF ≤26), after adjusting for Charlson Comorbidity Index (CCI), Body Mass Index (BMI), duration of PD (as self-reported by the patient) and smoking habit. LOWESS curve was used to graphically investigate the association between age and PDQ pain score. Of 110, 28 (25%) patients were ≤45 years old. Young patients had lower BMI [median (IQR) 24.3 (22.5-25.6) vs. 25.2 (23.7-27.8); p=0.01] and CCI [CCI≥1 in 1 patient (3.6%) vs. 23 (28%); p=0.014) compared to older patients. No differences were found between groups in terms of severity of the penile curvature, PD duration and plaque size. PDQ pain score was 6 (2.8-12.8) for young and 3 (0-8) for older patients (p=0.03). No differences were found in terms of PDQ-symptoms and bother scores, and for IIEF domain scores. At regression analysis, younger age was associated with significant higher PDQ-pain scores at presentation (Coeff 4.45; 95%CI 1.06:7.84; p=0.011). No further associations were observed between age and the other questionnaires. Younger PD patients are at higher risk of complaining penile pain at presentation. No difference in terms of symptoms, PD-associated bother, erectile function and other clinical and morphometric characteristics were found between younger and older patients at first assessment None

Evaluating the impact of time between radical prostatectomy (RP) and adjuvant radiation therapy (RT) on erectile function recovery (EFR)

ABSTRACT Introduction RT post-RP in men with PSA recurrence improves survival. It is also associated with a higher rate of urinary incontinence and erectile dysfunction (ED). Objective We attempted to evaluate if the time period between RP and adjuvant RT predicts EFR outcomes. Methods Men who received RT post-RP with ≥2 years post-RT follow-up were analyzed. ADT and RT pre-RP were exclusions. Demographics, comorbidities and pathological parameters and IIEF erectile function domain (EFD) scores were recorded. We report median EFD scores and factors correlated with EFR ≥24 months post-RT. Factors included: patient age, comorbidities, smoking status, baseline pre-RP and pre-RT Testosterone (T), prostate specific antigen (PSA), baseline EFD score, Nerve-Vascular bundle (NVB) status, and time between RP and RT. Results 126 men were included. Mean age at RP was 63 ± 7 years. Mean pre-RP T was 390 ± 222 ng/dL, PSA, 10.2 ± 10.4 ng/mL and median EFD score were 27 (IQR = 20-30). Median pre-RT T was 376.9 ± 187 ng/dL, PSA 0.25 ± 0.33 ng/mL, and median EFD score was 9 (IQR = 3-20). 54% of patients had bilateral NVB preservation, and 29.5% unilateral. 71% received ADT with their RT, the median duration of ADT exposure was 4.5 (IQR = 3-8.5) months. Median time between RP and RT was 14.9 months (IQR = 8.5-28.6) months; 41% had ≤1 year between RP and RT. 2 years post RT, median EFD was 9.5 (IQR = 3-22). 22% had a score ≥24. EFD score at follow-up was correlated with age at RP (r=-0.32, p&amp;lt;.001), and pre-RT EFD score (r=0.56, p&amp;lt;.001). Time between RP and RT did not correlate with EFD score at follow up (r=0.08, p=0.39). Conclusions In our prostate cancer patients cohort post-RP/RT, EFR is lower; almost 4 of 5 patients will have some ED degree at two years post-RT. The period time between RP and RT is not correlated with EFR post-RT. Disclosure Work supported by industry: no.

Initial Validation of the Radical Prostatectomy Questionnaire (RPQ): A New Patient Reported Outcome (PRO) to Assess Sexual Function following Radical Prostatectomy (RP)

ABSTRACT Introduction The only PRO validated for men after RP is Extended Prostate Cancer Index (EPIC). However, EPIC has weaknesses, including the lack of assessment of function in response to ED medication use, inclusion of ejaculation and absence of penile morphology assessment. We developed the RPQ to address these weaknesses. Methods RPQ is a 41-item scale assessing 5 domains: erectile function (EF), sexual desire (SD), orgasm (O), sexual satisfaction (SS), and penile morphology (PM). The EF domain assesses erections in response to no medication, PDE5i, intracavernosal injections (ICI). We used a multi-step process to develop the RPQ including: extensive literature review; development of primary domains; item generation and winnowing; feedback from 8 sexual medicine experts; and cognitive interviewing with 10 patients to verify content, wording, and response format. For validation, post-RP men completed the RPQ and the following PROs: IIEF, EPIC, SEAR, and the PROMISE measures. Participants completed the RPQ again within two weeks. Analyses include internal consistency (Cronbach's alpha), test-retest reliability, and convergent/discriminant validity. Cronbach's alpha and test-retest reliability ≥0.7 were considered acceptable. Results Mean age of the 311 men was 62±7. All domains of the RPQ demonstrated strong internal consistency (Cronbach's alpha=0.70-0.98) and test-retest reliability (ICC= 0.82-0.99). There was sound convergent validity for the RPQ EF domains with/without medication demonstrate by correlations with the IIEF Erectile Function Domain (EFD) (r=0.31 to 0.70, p&amp;lt;.05). Discriminate validity was demonstrated for RPQ EF domains with/without medication with moderate correlations with the SEAR and PROMIS scales (r=0.23 to r=0.59, p&amp;lt;.01). There was also sound convergent validity for RPQ SD, O, and SS domains with strong correlations with the PROMIS desire, orgasm, and satisfaction scales (r=0.66 to r=0.77, p&amp;lt;.01), with discriminant validity demonstrating moderate correlations with SEAR Self-Esteem (r=0.38 to r=0.46, p&amp;lt;.01) and Sexual Bother (r=-0.43 to 0.66, p&amp;lt;.01). The RPQ PM domain demonstrated convergent validity with moderate correlations with the IIEF EFD and Orgasm domain (r=-0.20; r=0.33, p&amp;lt;.01, respectively) and discriminant validity with low, non-significant correlation with EPIC Urinary function. Conclusion Initial validation of the RPQ supports the reliability and validity of the scale. Disclosure Work supported by industry: no.

PD09-07 HYPERESTROGENISM IS ASSOCIATED WITH SEXUAL FUNCTION IMPAIRMENT IN MEN—FINDINGS FROM A CROSS-SECTIONAL, REAL-LIFE STUDY

You have accessJournal of UrologyCME1 May 2022PD09-07 HYPERESTROGENISM IS ASSOCIATED WITH SEXUAL FUNCTION IMPAIRMENT IN MEN—FINDINGS FROM A CROSS-SECTIONAL, REAL-LIFE STUDY Luca Boeri, Paolo Capogrosso, Giuseppe Fallara, Walter Cazzaniga, Luigi Candela, Federico Belladelli, Edoardo Pozzi, Massimiliano Raffo, Antonio Costa, Christian Corsini, Daniele Cignoli, Nicolò Schifano, Gianmarco Colandrea, Alessia d'Arma, Eugenio Ventimiglia, Rayan Matloob, Federico Dehò, Francesco Montorsi, and Andrea Salonia Luca BoeriLuca Boeri More articles by this author , Paolo CapogrossoPaolo Capogrosso More articles by this author , Giuseppe FallaraGiuseppe Fallara More articles by this author , Walter CazzanigaWalter Cazzaniga More articles by this author , Luigi CandelaLuigi Candela More articles by this author , Federico BelladelliFederico Belladelli More articles by this author , Edoardo PozziEdoardo Pozzi More articles by this author , Massimiliano RaffoMassimiliano Raffo More articles by this author , Antonio CostaAntonio Costa More articles by this author , Christian CorsiniChristian Corsini More articles by this author , Daniele CignoliDaniele Cignoli More articles by this author , Nicolò SchifanoNicolò Schifano More articles by this author , Gianmarco ColandreaGianmarco Colandrea More articles by this author , Alessia d'ArmaAlessia d'Arma More articles by this author , Eugenio VentimigliaEugenio Ventimiglia More articles by this author , Rayan MatloobRayan Matloob More articles by this author , Federico DehòFederico Dehò More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Andrea SaloniaAndrea Salonia More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002535.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: High serum estrogens levels have been associated with higher rates of heart attacks, strokes, and prostate cancer. Moreover, hyperestrogenism is believed to be harmful to male sexuality. We aimed to investigate the prevalence of and the impact of hyperestrogenism on sexual functioning in a cohort of men seeking medical attention for new onset erectile dysfunction (ED) in the real-life setting. METHODS: Data from 547 men seeking first medical help for new-onset ED at a single andrology centre were analyzed. Patients were assessed with a thorough medical and sexual history. Comorbidities were scored with the Charlson Comorbidity Index (CCI). All patients completed the International Index of Erectile Function (IIEF); the IIEF-Erectile function (IIEF-EF) domain was categorized according to Cappelleri’s criteria. Circulating hormones were measured in every patient. Hyperestrogenism was defined as estradiol (E2) levels >42.6 pg/mL (Tan RS et al. 2015). Descriptive statistics and logistic/linear regression models tested the association between hyperestrogenism and IIEF scores. RESULTS: Overall, 96 (17.6%) patients had serum estrogen levels suggestive for hyperestrogenism. Men with hyperestrogenism were older [median (IQR) 46 (35-59) vs. 44 (31-56) years; p <0.001], had more comorbidities [CCI≥1: 26.0% vs. 7.4%; p <0.001] and higher serum testosterone (TT) levels [5.4 (5.2-8.0) vs. 4.3 (4.1-5.7); p=0.01] than those with normal E2 values. A higher rate of severe ED was found in men with elevated E2 levels (49.0% vs. 29.9%; p=0.01). Moreover, the IIEF-orgasmic function (IIEF-OF) domain was lower in ED men with hyperestrogenism than those with normal E2 values [6 (3-10) vs. 9 (5-10), p=0.03]. Serum E2 levels were positively correlated with TT levels (rho 0.26, p <0.001), but negatively correlated with IIEF-OF (rho -0.2, p<0.01) and IIEF-EF scores (rho -0.33, p <0.001). At multivariable logistic regression analysis, hyperestrogenism (OR 2.44, p=0.02) was associated with severe ED after accounting for age, BMI, CCI and serum TT values. CONCLUSIONS: One out of five men seeking first medical help for ED showed elevated serum E2 values in the real-life setting. Hyperestrogenism was associated with health significant comorbidities, orgasmic function impairment and higher severity of ED. Source of Funding: none © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e179 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Luca Boeri More articles by this author Paolo Capogrosso More articles by this author Giuseppe Fallara More articles by this author Walter Cazzaniga More articles by this author Luigi Candela More articles by this author Federico Belladelli More articles by this author Edoardo Pozzi More articles by this author Massimiliano Raffo More articles by this author Antonio Costa More articles by this author Christian Corsini More articles by this author Daniele Cignoli More articles by this author Nicolò Schifano More articles by this author Gianmarco Colandrea More articles by this author Alessia d'Arma More articles by this author Eugenio Ventimiglia More articles by this author Rayan Matloob More articles by this author Federico Dehò More articles by this author Francesco Montorsi More articles by this author Andrea Salonia More articles by this author Expand All Advertisement PDF DownloadLoading ...

Hyperestrogenism is associated with sexual function impairment in men – findings from a cross-sectional, real-life study

ABSTRACT Introduction High serum estrogens levels have been associated with higher rates of heart attacks, strokes, and prostate cancer. Moreover, hyperestrogenism is believed to be harmful to male sexuality. Objectives We aimed to investigate the prevalence of and the impact of hyperestrogenism on sexual functioning in a cohort of men seeking medical attention for new onset erectile dysfunction (ED) in the real-life setting. Methods Data from 481 men seeking first medical help for new-onset ED at a single andrology centre were analyzed. Patients were assessed with a thorough medical and sexual history. Comorbidities were scored with the Charlson Comorbidity Index (CCI). All patients completed the International Index of Erectile Function (IIEF) and the IIEF-Erectile function (IIEF-EF) domain was categorized according to Cappelleri's criteria. Circulating hormones were measured in every patient. Hyperestrogenism was defined as estrogen (E2) levels &amp;gt;42.6 pg/mL (Tan RS et al. 2015). Descriptive statistics and logistic/linear regression models tested the association between hyperestrogenism and IIEF scores. Results Overall, 88 (18.3%) patients had serum estrogen levels suggestive for hyperestrogenism. Men with hyperestrogenism were older [median (IQR) 46 (34-58) vs. 44 (32-55) years; p&amp;lt;0.001], had more comorbidities [CCI≥2: 18 (20.5%) vs. 28 (7.1%); p&amp;lt;0.001] and higher serum testosterone (TT) levels [5.4 (4.2-7.3) vs. 4.3 (3.1-5.7); p=0.02] than those with normal E2 values. A higher rate of severe ED was found in men with elevated E2 levels (48.9% vs. 30%; p=0.02). Moreover, the IIEF-orgasmic function (IIEF-OF) domain was lower in ED men with hyperestrogenism than those with normal E2 values [6 (3-10) vs. 9 (6-10), p=0.03]. Serum E2 levels were positively correlated with TT levels (rho 0.25, p&amp;lt;0.001), but negatively correlated with IIEF-OF scores (rho -0.17, p=0.005) and IIEF-EF scores (rho -0.32, p&amp;lt;0.001) (Figure 1). At multivariable logistic regression analysis, hyperestrogenism (OR 2.37, p=0.03) was associated with severe ED after accounting for age, BMI, CCI and serum T values. Conclusions One out of five men seeking first medical help for ED showed elevated serum E2 values in the real-life setting. Hyperestrogenism was associated with health significant comorbidities, orgasmic function impairment and higher severity of ED. Disclosure Work supported by industry: no.

Prevalence and predictors of unrecognized low sexual desire in men with new onset erectile dysfunction – findings from a cross-sectional, real-life study

ABSTRACT Introduction The interrelationship between male sexual desire and erectile dysfunction (ED) has been variously investigated. Objectives We aimed to investigate the prevalence of and the predictors of unrecognized low sexual desire (LSD) in a cohort of men seeking medical help for new onset ED in the real-life setting. Methods Data from 1509 men seeking first medical help for new-onset ED at a single andrology centre between 01/2010 and 01/2020 were analyzed. Patients were assessed with a thorough medical and sexual history. Comorbidities were scored with the Charlson Comorbidity Index (CCI). All participants were asked to self-report the presence of LSD. Moreover, patients completed the International Index of Erectile Function (IIEF) and the Beck Depression Inventory (BDI). Depressive symptoms were defined as BDI ≥11. The median value of the IIEF-Sexual desire domain (IIEF-SD) was used to categorize the cohort in low SD (IIEF-SD &amp;lt;7) vs. normal SD (IIEF-SD ≥7). The IIEF-Erectile function (IIEF-EF) domain was categorized according to Cappelleri's criteria. Circulating hormones were measured in every patient. Hypogonadism was defined as total testosterone (tT) &amp;lt; 3.0 ng/mL. Descriptive statistics and logistic regression models tested the association between clinical variables and unrecognized LSD. Results Overall, 312 (20.7%) patients self-reported LSD and were excluded from further analyses. Of 1197 patients not self-reporting LSD, 369 (30.8%) had IIEF-SD &amp;lt;7 (arbitrarily defined as unrecognized LSD). Patients with unrecognized LSD were older [median (IQR) 54 yrs (41-63) vs. 49 yrs (36-59), p&amp;lt;0.001], had lower IIEF-EF [10 (5-20) vs. 22 (11-28)] but higher BDI [6 (3-12) vs. 4 (1-8)] and lower tT [4.3 (3.2-5.7) vs. 4.7 (3.2-7.3) ng/ml] (all p&amp;lt;0.001) than men without LSD. Overall, men with unrecognized LSD presented a higher rate of severe ED (50% vs. 24%, p&amp;lt;0.001), and of BDI suggestive for depressive symptoms (30.6% vs. 18.3%) and of hypogonadism (19.9% vs. 10%) (all p&amp;lt;0.001). At multivariable logistic regression analysis, lower tT, despite not suggestive for hypogonadism (OR 0.91, p=0.03), lower IIEF-EF (OR 0.94, p&amp;lt;0.001) and BDI suggestive for depressive symptoms (OR 1.83, p&amp;lt;0.001) were found to be independent predictors of unrecognized LSD, after accounting for age. Conclusions One out of three men seeking first medical help for ED showed unrecognized LSD according to the IIEF-SD domain scores. Men with unrecognized LSD were older, had higher rates of severe ED and depressive symptoms and lower tT values despite not suggestive for hypogonadism than men with normal SD. A detailed investigation of sexual desire should be always included in the diagnostic work-up of men with ED, in order to better tailoring patient therapeutic management. Disclosure Work supported by industry: no.

Peyronie's disease in young adults: Symptomatic burden and clinical characteristics

ABSTRACT Introduction Peyronie's disease is a benign condition involving the tunica albuginea of the corpora cavernosa of the penis. Objectives To investigate whether patients’ age has an impact in terms of Peyronie's disease (PD) clinical characteristics at presentation. Methods Data from a group of 110 consecutive patients aged &amp;gt;18 and &amp;lt;70 years with PD and seeking first medical attention at a single andrological tertiary-referral centre, with a complete clinical assessment and who completed the IIEF-15 and PDQ questionnaires were included in the study. Descriptive statistics was used to compare categorical and continuous variables, between young (≤45 years) and old (&amp;gt;45 years) patients at presentation. Linear and logistic regression analyses tested the association between age and PDQ subscales (Pain, Bother and Symptoms) or IIEF-erectile function domain scores (IIEF-EF ≤26), after adjusting for Charlson Comorbidity Index (CCI), Body Mass Index (BMI), duration of PD (as self-reported by the patient) and smoking habit. LOWESS curve was used to graphically investigate the association between age and PDQ pain score. Results Of 110, 28 (25%) patients were ≤45 years old. Young patients had lower BMI [median (IQR) 24.3 (22.5-25.6) vs. 25.2 (23.7-27.8); p=0.01] and CCI [CCI≥1 in 1 patient (3.6%) vs. 23 (28%); p=0.014) compared to older patients. No differences were found between groups in terms of severity of the penile curvature, PD duration and plaque size. PDQ pain score was 6 (2.8-12.8) for young and 3 (0-8) for older patients (p=0.03). No differences were found in terms of PDQ-symptoms and bother scores, and for IIEF domain scores. At regression analysis, younger age was associated with significant higher PDQ-pain scores at presentation (Coeff 4.45; 95%CI 1.06:7.84; p=0.011). No further associations were observed between age and the other questionnaires. The figure depicts the higher PDQ-pain scores in young compared to older age. Conclusion Younger PD patients are at higher risk of complaining penile pain at presentation. No difference in terms of symptoms, PD-associated bother, erectile function and other clinical and morphometric characteristics were found between younger and older patients at first assessment. Disclosure Work supported by industry: no.

Evaluating the Impact of Time Between Radical Prostatectomy (RP) and Adjuvant Radiation Therapy (RT) on Erectile Function Recovery (EFR)

ABSTRACT Introduction RT post-RP in men with PSA recurrence improves survival. It is also associated with a higher rate of urinary incontinence and erectile dysfunction (ED). Objective We attempted to evaluate if the time period between RP and adjuvant RT predicts EFR outcomes. Methods Men who received RT post-RP with ≥2 years post-RT follow-up were analyzed. ADT and RT pre-RP were exclusions. Demographics, comorbidities and pathological parameters and IIEF erectile function domain (EFD) scores were recorded. We report median EFD scores and factors correlated with EFR ≥24 months post-RT. Factors included: patient age, comorbidities, smoking status, baseline pre-RP and pre-RT Testosterone (T), prostate specific antigen (PSA), baseline EFD score, Nerve-Vascular bundle (NVB) status, and time between RP and RT. Results 126 men were included. Mean age at RP was 63 ± 7 years. Mean pre-RP T was 390 ± 222 ng/dL, PSA, 10.2 ± 10.4 ng/mL and median EFD score were 27 (IQR = 20-30). Median pre-RT T was 376.9 ± 187 ng/dL, PSA 0.25 ± 0.33 ng/mL, and median EFD score was 9 (IQR = 3-20). 54% of patients had bilateral NVB preservation, and 29.5% unilateral. 71% received ADT with their RT, the median duration of ADT exposure was 4.5 (IQR = 3-8.5) months. Median time between RP and RT was 14.9 months (IQR = 8.5-28.6) months; 41% had ≤1 year between RP and RT. 2 years post RT, median EFD was 9.5 (IQR = 3-22). 22% had a score ≥24. EFD score at follow-up was correlated with age at RP (r=-0.32, p&amp;lt;.001), and pre-RT EFD score (r=0.56, p&amp;lt;.001). Time between RP and RT did not correlate with EFD score at follow up (r=0.08, p=0.39). Conclusions In our prostate cancer patients cohort post-RP/RT, EFR is lower; almost 4 of 5 patients will have some ED degree at two years post-RT. The period time between RP and RT is not correlated with EFR post-RT. Disclosure No

Initial Validation of the Radical Prostatectomy Questionnaire (RPQ): A New Patient Reported Outcome (PRO) to Assess Sexual Function following Radical Prostatectomy (RP)

ABSTRACT Introduction The only PRO validated for men after RP is Extended Prostate Cancer Index (EPIC). However, EPIC has weaknesses, including the lack of assessment of function in response to ED medication use, inclusion of ejaculation and absence of penile morphology assessment. Objective To develop the RPQ to address weaknesses in current PROs that assess sexual function following RP. Methods RPQ is a 41-item scale assessing 5 domains: erectile function (EF), sexual desire (SD), orgasm (O), sexual satisfaction (SS), and penile morphology (PM). The EF domain assesses erections in response to no medication, PDE5i, intracavernosal injections (ICI). We used a multi-step process to develop the RPQ including: extensive literature review; development of primary domains; item generation and winnowing; feedback from 8 sexual medicine experts; and cognitive interviewing with 10 patients to verify content, wording, and response format. For validation, post-RP men completed the RPQ and the following PROs: IIEF, EPIC, SEAR, and the PROMISE measures. Participants completed the RPQ again within two weeks. Analyses include internal consistency (Cronbach's alpha), test-retest reliability, and convergent/discriminant validity. Cronbach's alpha and test-retest reliability ≥0.7 were considered acceptable. Results Mean age of the 311 men was 62±7. All domains of the RPQ demonstrated strong internal consistency (Cronbach's alpha=0.70-0.98) and test-retest reliability (ICC= 0.82-0.99). There was sound convergent validity for the RPQ EF domains with/without medication demonstrate by correlations with the IIEF Erectile Function Domain (EFD) (r=0.31 to 0.70, p&amp;lt;.05). Discriminate validity was demonstrated for RPQ EF domains with/without medication with moderate correlations with the SEAR and PROMIS scales (r=0.23 to r=0.59, p&amp;lt;.01). There was also sound convergent validity for RPQ SD, O, and SS domains with strong correlations with the PROMIS desire, orgasm, and satisfaction scales (r=0.66 to r=0.77, p&amp;lt;.01), with discriminant validity demonstrating moderate correlations with SEAR Self-Esteem (r=0.38 to r=0.46, p&amp;lt;.01) and Sexual Bother (r=-0.43 to 0.66, p&amp;lt;.01). The RPQ PM domain demonstrated convergent validity with moderate correlations with the IIEF EFD and Orgasm domain (r=-0.20; r=0.33, p&amp;lt;.01, respectively) and discriminant validity with low, non-significant correlation with EPIC Urinary function. Conclusions Initial validation of the RPQ supports the reliability and validity of the scale. Disclosure No

MP27-03 EVALUATING THE IMPACT OF TIME BETWEEN RADICAL PROSTATECTOMY (RP) AND ADJUVANT RADIATION THERAPY (RT) ON ERECTILE FUNCTION RECOVERY (EFR)

You have accessJournal of UrologySexual Function/Dysfunction: Evaluation I (MP27)1 Sep 2021MP27-03 EVALUATING THE IMPACT OF TIME BETWEEN RADICAL PROSTATECTOMY (RP) AND ADJUVANT RADIATION THERAPY (RT) ON ERECTILE FUNCTION RECOVERY (EFR) Jose M. Flores, Nicole Benfante, Elizabeth Schofield, and John P. Mulhall Jose M. FloresJose M. Flores More articles by this author , Nicole BenfanteNicole Benfante More articles by this author , Elizabeth SchofieldElizabeth Schofield More articles by this author , and John P. MulhallJohn P. Mulhall More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002024.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: RT post-RP in men with PSA recurrence improves survival. It is also associated with a higher rate of urinary incontinence and erectile dysfunction (ED). We attempted to evaluate if the time period between RP and adjuvant RT predicts EFR outcomes. METHODS: Men who received RT post-RP with ≥2 years post-RT follow-up were analyzed. ADT and RT pre-RP were exclusions. Demographics, comorbidities and pathological parameters and IIEF erectile function domain (EFD) scores were recorded. We report median EFD scores and factors correlated with EFR ≥24 months post-RT. Factors included: patient age, comorbidities, smoking status, baseline pre-RP and pre-RT Testosterone (T), prostate specific antigen (PSA), baseline EFD score, Nerve-Vascular bundle (NVB) status, and time between RP and RT. RESULTS: 126 men were included. Mean age at RP was 63±7 years. Mean pre-RP T was 390±222 ng/dL, PSA, 10.2±10.4 ng/mL and median EFD score were 27 (IQR=20–30). Median pre-RT T was 376.9±187 ng/dL, PSA 0.25±0.33 ng/mL, and median EFD score was 9 (IQR = 3–20). 54% of patients had bilateral NVB preservation, and 29.5% unilateral. 71% received ADT with their RT, the median duration of ADT exposure was 4.5 (IQR = 3–8.5) months. Median time between RP and RT was 14.9 months (IQR = 8.5–28.6) months; 41% had ≤1 year between RP and RT. 2 years post RT, median EFD was 9.5 (IQR = 3–22). 22% had a score ≥24. EFD score at follow-up was correlated with age at RP (r=-0.32, p<0.001), and pre-RT EFD score (r=0.56, p<0.001). Time between RP and RT did not correlate with EFD score at follow up (r=0.08, p=0.39). CONCLUSIONS: In our prostate cancer patients cohort post-RP/RT, EFR is lower; almost 4 of 5 patients will have some ED degree at two years post-RT. The period time between RP and RT is not correlated with EFR post-RT. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e472-e473 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jose M. Flores More articles by this author Nicole Benfante More articles by this author Elizabeth Schofield More articles by this author John P. Mulhall More articles by this author Expand All Advertisement Loading ...

MP27-13 PREVALENCE AND PREDICTORS OF UNRECOGNIZED LOW SEXUAL DESIRE IN MEN WITH NEW ONSET ERECTILE DYSFUNCTION—FINDINGS FROM A CROSS-SECTIONAL, REAL-LIFE STUDY

You have accessJournal of UrologySexual Function/Dysfunction: Evaluation I (MP27)1 Sep 2021MP27-13 PREVALENCE AND PREDICTORS OF UNRECOGNIZED LOW SEXUAL DESIRE IN MEN WITH NEW ONSET ERECTILE DYSFUNCTION—FINDINGS FROM A CROSS-SECTIONAL, REAL-LIFE STUDY Luca Boeri, Paolo Capogrosso, Walter Cazzaniga, Luigi Candela, Giuseppe Fallara, Edoardo Pozzi, Federico Belladelli, Nicolò Schifano, Daniele Cignoli, Gianmarco Colandrea, Massimiliano Raffo, Costantino Abbate, Francesco Montorsi, and Andrea Salonia Luca BoeriLuca Boeri More articles by this author , Paolo CapogrossoPaolo Capogrosso More articles by this author , Walter CazzanigaWalter Cazzaniga More articles by this author , Luigi CandelaLuigi Candela More articles by this author , Giuseppe FallaraGiuseppe Fallara More articles by this author , Edoardo PozziEdoardo Pozzi More articles by this author , Federico BelladelliFederico Belladelli More articles by this author , Nicolò SchifanoNicolò Schifano More articles by this author , Daniele CignoliDaniele Cignoli More articles by this author , Gianmarco ColandreaGianmarco Colandrea More articles by this author , Massimiliano RaffoMassimiliano Raffo More articles by this author , Costantino AbbateCostantino Abbate More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Andrea SaloniaAndrea Salonia More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002024.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The interrelationship between male sexual desire and erectile dysfunction (ED) has been variously investigated. We aimed to investigate the prevalence and the predictors of unrecognized low sexual desire (LSD) in a cohort of men seeking medical help for new onset ED in the real-life setting. METHODS: Data from 1509 men seeking first medical help for new-onset ED at a single andrology centre in 2010-2020 were analyzed. Patients were assessed with a thorough medical and sexual history. Comorbidities were scored with the Charlson Comorbidity Index (CCI). All participants were asked to self-report the presence of LSD and to complete the International Index of Erectile Function (IIEF) and the Beck Depression Inventory (BDI). Depressive symptoms were defined as BDI≥11. The median value of the IIEF-Sexual desire domain (IIEF-SD) was used to categorize the cohort in low SD (IIEF-SD<7, defined as unrecognized LSD) vs. normal SD (IIEF-SD≥7). The IIEF-Erectile function (IIEF-EF) domain was categorized according to Cappelleri’s criteria. Serum hormones were measured in every patient. Hypogonadism was defined as total testosterone (tT)<3.0 ng/mL. Descriptive statistics and logistic regression models tested the association between clinical variables and unrecognized LSD. RESULTS: Overall, 312 (20.7%) patients self-reported LSD and were excluded from further analyses. Of 1197 patients not self-reporting LSD, 369 (30.8%) had IIEF-SD<7. Patients with unrecognized LSD were older [median (IQR) 54 yrs (41-63) vs. 49 (36-59)], had lower IIEF-EF [10 (5-20) vs. 22 (11-28)], higher BDI [6 (3-12) vs. 4 (1-8)] and lower tT [4.3 (3.2-5.7) vs. 4.7 (3.2-7.3) ng/ml] (all p<0.001) than men without LSD. Men with unrecognized LSD presented a higher rate of severe ED (50% vs. 24%, p<0.001), of BDI≥11 (30.6% vs. 18.3%) and tT<3.0ng/mL (19.9% vs. 10%) (all p<0.001). At multivariable logistic regression analysis, lower tT (OR 0.91, p=0.03), lower IIEF-EF (OR 0.94, p<0.001) and BDI≥11 (OR 1.83, p<0.001) were found to be independent predictors of unrecognized LSD, after accounting for age. CONCLUSIONS: One out of three men seeking first medical help for ED showed unrecognized LSD. Men with unrecognized LSD were older, had more severe ED and depressive symptoms and lower tT values despite not suggestive for hypogonadism than men with normal SD. Thus, a detailed investigation of sexual desire should be always included in the diagnostic work-up of men with ED. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e476-e476 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Luca Boeri More articles by this author Paolo Capogrosso More articles by this author Walter Cazzaniga More articles by this author Luigi Candela More articles by this author Giuseppe Fallara More articles by this author Edoardo Pozzi More articles by this author Federico Belladelli More articles by this author Nicolò Schifano More articles by this author Daniele Cignoli More articles by this author Gianmarco Colandrea More articles by this author Massimiliano Raffo More articles by this author Costantino Abbate More articles by this author Francesco Montorsi More articles by this author Andrea Salonia More articles by this author Expand All Advertisement Loading ...

Influence of COVID-19 pandemic on sexuality: a cross-sectional study among couples in Turkey.

Coronavirus disease 2019 (COVID-19) pandemic has been continuing to affect the lives of all people globally. It has been shown that restrictions due to changes in lifestyles lead to mental health problems. This study aims to investigate the effect of COVID-19 pandemic on couples’ sexuality. A total of 245 volunteers (148 men and 97 women) were enrolled in the study. Generalized Anxiety Disorder-7, Patient Health Questionnaire, Perceived Stress Scale were administered to screen anxiety and depression symptoms. International Index of Erectile Function (IIEF-15) and Female Sexual Function Index (FSFI) along with self-constructed sexual behavior questionnaire were administered to participants, in order to evaluate sexual functions and behavioral changes during the pandemic. Sexual function scores (IIEF erectile function domain and total FSFI) during pandemic (24.55 ± 5.79 and 24.87 ± 7.88, respectively) were lower compared to the prepandemic period (26.59 ± 4.51 and 26.02 ± 6.22, respectively) (p = 0.001 and p = 0.027, respectively). During pandemic compared to prepandemic period, the frequency of sexual intercourse decreased in men (p = 0.001) and women (p = 0.001) while sexual avoidance and solitary sexual approach behaviors (masturbation or watching sexual content videos, etc.) increased in men (p = 0.001) and women (p = 0.022). However, the couples that spent more time together during the pandemic reported better sexual function scores (men; p = 0.001, women; p = 0.006). Although this is the first study evaluating couples from Turkey with a convenience sample, further studies with a greater number may better elucidate the effects of this pandemic on sexuality.

PD26-01 INITIAL VALIDATION OF THE RADICAL PROSTATECTOMY QUESTIONNAIRE (RPQ)

INTRODUCTION AND OBJECTIVE: The only PRO validated for men after RP is Extended Prostate Cancer Index (EPIC). However, EPIC has weaknesses, including the lack of assessment of function in response to ED medication use, inclusion of ejaculation and absence of penile morphology assessment. We developed the RPQ to address these weaknesses. METHODS: RPQ is a 41-item scale assessing 5 domains: erectile function (EF), sexual desire (SD), orgasm (O), sexual satisfaction (SS), and penile morphology (PM). The EF domain assesses erections in response to no medication, PDE5i, intracavernosal injections (ICI). We used a multi-step process to develop the RPQ including: extensive literature review; development of primary domains; item generation and winnowing; feedback from 8 sexual medicine experts; and cognitive interviewing with 10 patients to verify content, wording, and response format. For validation, post-RP men completed the RPQ and the following PROs: IIEF, EPIC, SEAR, and the PROMISE measures. Participants completed the RPQ again within two weeks. Analyses include internal consistency (Cronbach’s alpha), test-retest reliability, and convergent/discriminant validity. Cronbach’s alpha and correlations ≥0.7 were considered acceptable. RESULTS: Mean age of the 311 men was 62±7. All domains of the RPQ demonstrated strong internal consistency (Cronbach’s alpha=0.70-0.98) and test-retest reliability (ICC= 0.82-0.99). There was sound convergent validity for the RPQ EF domains with/without medication demonstrated by correlations with the IIEF Erectile Function Domain (EFD) (r=0.31 to 0.70, p<.05). Discriminate validity was demonstrated for RPQ EF domains with/without medication with moderate correlations with the SEAR and PROMIS scales (r=0.23 to r=0.59, p<.01). There was also sound convergent validity for RPQ SD, O, and SS domains with strong correlations with the PROMIS desire, orgasm, and satisfaction scales (r=0.66 to r=0.77, p<.01), with discriminant validity demonstrating moderate correlations with SEAR Self-Esteem (r=0.38 to r=0.46, p<.01) and Sexual Bother (r=-0.43 to 0.66, p<.01). The RPQ PM domain demonstrated convergent validity with moderate correlations with the IIEF EFD and Orgasm domain (r=-0.20; r=0.33, p<.01, respectively) and discriminant validity with low, non-significant correlation with EPIC Urinary function. CONCLUSIONS: Initial validation of the RPQ supports the reliability and validity of the scale. Source of Funding: CIACT

160 Predictors of Worsening Erectile Function in Men With Functional Erections Early After Radical Prostatectomy

Prior data suggest that men with good erectile function (EF) early after radical prostatectomy (RP) can worsen their EF over the first 6 months postoperatively. We aimed to determine the prevalence and predictors of worsening EF after RP. 1,655 men who (i) underwent RP (ii) completed IIEF EF domain (EFD) pre-RP and (iii) serially post-RP constituted the population. Functional erections (FE) were defined as EFD score ≥24. We analyzed factors predicting FE at 3 months post-RP as well as factors predicting a decrease in FE between 3-6 months, defined as a two point drop or more in EFD score. Multivariable logistic regression (MVA) models were used with the following predictors: patient age at RP, baseline and 3-month EFD scores, PDE5i use at 3m (always vs other), diabetes, hypertension, hyperlipidemia, sleep apnea, cigarette smoking status (never vs current vs former), and nerve-sparing status (NSS; none vs unilateral vs bilateral).