You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Evaluation1 Apr 20111331 PREOPERATIVE ERECTILE DYSFUNCTION IS ASSOCIATED WITH LARGER TUMOR VOLUMES -AN ANALYSIS FROM THE DUKE PROSTATE CENTER DATABASE Masaki Kimura, Lionel Bañez, Jim Qi, Leah Gerber, Thomas Polascik, Craig Donatucci, and Judd Moul Masaki KimuraMasaki Kimura Durham, NC More articles by this author , Lionel BañezLionel Bañez Durham, NC More articles by this author , Jim QiJim Qi Durham, NC More articles by this author , Leah GerberLeah Gerber Durham, NC More articles by this author , Thomas PolascikThomas Polascik Durham, NC More articles by this author , Craig DonatucciCraig Donatucci Durham, NC More articles by this author , and Judd MoulJudd Moul Durham, NC More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1151AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Among prostate cancer (PCa) patients, it has been reported that preoperative erectile dysfunction (ED) is associated with increased risk for death from causes other than PCa. It was hypothesized that ED patients were also at considerably increased risk for adverse cardiovascular events. However, the impact of preoperative ED on pathological features of PCa is unknown. We, therefore, sought to investigate the relationship between preoperative erectile function (EF) and pathological features of CaP at the time of surgery in men undergoing radical prostatectomy. METHODS We analyzed data from the Duke Prostate Center database on 625 consecutive patients with complete records including sexual function evaluations who underwent RP between 2001 and 2010. Preoperative EF was assessed using sexual function scores of the Expanded Prostate Cancer Index Composite (EPIC) questionnaire. Crude and adjusted linear and logistic regression models were used to investigate the association between preoperative EF and risk for adverse pathological parameters, including high tumor volume (TV), extracapsular extension (ECE), seminal vesicle invasion (SVI) and positive surgical margins (PSM). Preoperative EF was adjusted for age, race, preoperative PSA, clinical T stage, and prostatectomy type. RESULTS Of 625 patients, 201 (32.2%) men underwent retropubic RP, 136 (21.8%) underwent perineal RP, and 288 (46.0%) underwent robotic-assisted laparoscopic RP. Bilateral, unilateral, non-nerve-sparing procedures were performed in 316 (50.5%), 168 (26.9%), and 141 (22.6%) patients, respectively. There was no difference with regards to distribution of age, race, PSA, clinical stage and prostatectomy type between patients with normal EF and those with ED. In univariate analyses, higher preoperative EF scores were significantly associated with slightly decreased risk for ECE (OR 0.99; 95%CI 0.98-1.00; P=0.038), and lower TV (coef, −0.04; 95%CI, −0.07–0.09; P=0.012). After adjusting for covariates, only TV (coef, −0.04; 95%CI, −0.08–0.05; P=0.024) was found to be negatively associated with EF. CONCLUSIONS Men with decreased EF were more likely to have larger tumors compared to men with higher EF scores. These results suggest that, apart from increased risk for non-PCa mortality in men with ED, the risk for adverse PCa outcomes may also be negatively impacted by ED or ED-related comorbidities. Alternatively, larger tumors may also contribute to ED locally via pressure effects or neural infiltration. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e532 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Masaki Kimura Durham, NC More articles by this author Lionel Bañez Durham, NC More articles by this author Jim Qi Durham, NC More articles by this author Leah Gerber Durham, NC More articles by this author Thomas Polascik Durham, NC More articles by this author Craig Donatucci Durham, NC More articles by this author Judd Moul Durham, NC More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...