Boyd Viers

MP46-05 PREDICTING URETHRAL ATROPHY IN PATIENTS UNDERGOING PRIMARY PLACEMENT OF ARTIFICIAL URINARY SPHINCTER

INTRODUCTION AND OBJECTIVES: Long-term data on effects of testosterone therapy (TTh) on urinary function in hypogonadal men published so far are from observational studies without a control group. We present registry data including an untreated hypogonadal control group. METHODS: Registry study in 656 men with testosterone 350 ng/dL and hypogonadal symptoms. 360 received TU 1000 mg/12 weeks following an initial 6-week interval (T-group). 296 men opted against TTh and served as controls (CTRL). 8-year data are presented. Changes over time between groups were compared by a mixed effects model for repeated measures with a random effect for intercept and fixed effects for time, group and their interaction. Changes were adjusted for age, weight, waist circumference, blood pressure, fasting glucose, lipids and quality of life to account for baseline differences between groups. In order to further validate results, propensity matching was performed for baseline age, BMI, and waist circumference. 82 men in each group fulfilled criteria. RESULTS: Total group: mean age was 57.4 7.3 years in the T-group and 64.8 4.3 in CTRL, median follow-up time 7 years for both. In the T-group, IPSS decreased from 6.4 4.0 to 2.1 1.0 with a change from baseline of 5.0 points. In CTRL, IPSS increased from 4.5 2.0 to 6.5 2.6 after 8 years by 1.8 points (p<0.0001 for both). Residual urine volume decreased from 47.3 22.8 to 13.7 4.6 mL in the T-group and increased from 48.3 16.3 to 64.5 22.2 in CTRL. Prostate volume increased from 29.2 10.4 to 31.1 11.5 mL in the T-group (p<0.0001) and fell from 34.5 5.9 to 33.5 12.0 in CTRL (NS). Propensity-matched group: mean age was 61.7 5.1 years in the T-group and 61.6 2.9 in CTRL, median follow-up time 8 years in the T-group and 7 in CTRL. In the T-group, IPSS decreased from 7.4 4.2 to 2.0 0.9 with a change from baseline of 5.4 points. In CTRL, IPSS increased from 4.3 2.3 to 7.0 2.6 after 8 years by 1.9 points (p<0.0001 for both). Residual urine volume decreased from 50.6 23.6 to 14.0 4.7 mL in the T-group and increased from 45.7 16.4 to 64.6 16.7 in CTRL. Prostate volume increased from 31.4 12.0 to 33.2 12.7 mL in the T-group (p<0.0001) and from 33.4 6.2 to 33.6 11.0 in CTRL (NS). CONCLUSIONS: Urinary function is improved and preserved for a prolonged period of time by TTh in hypogonadal men and deteriorates in untreated hypogonadal men. The observed changes seem independent of prostate volume.

PD31-07 CONCURRENT PENILE TRACTION THERAPY IN MEN UNDERGOING COLLAGENASE CLOSTRIDIUM HISTOLYTICUM FOR PEYRONIE’S DISEASE

& physical 11 6; pain 5 6; bother 7 4. Theses trends are similar to PDQ scores reported in the phase 3 Xiaflex studies (IMPRESS I & II). On MVA, higher CES-D scores were related to the inability to penetrate (b1⁄40.18, p1⁄40.04). Lower SEAR total scores were related to inability to penetrate (b1⁄4-0.30 p1⁄40.01) and greater curvature (b1⁄40.25, p1⁄40.04). Higher PDQ Bother scores were related to greater curvature (b1⁄40.33, p1⁄40.02), and marginally related to perceived loss of penile length (b1⁄40.24, p1⁄40.06) and inability to penetrate (b1⁄40.22 p1⁄40.09). CONCLUSIONS: The data reinforce the significant prevalence of depression as well as psychosexual and relationship health in degree to men with ED. Common predictors of psychological and relationship variables were inability to penetrate, greater curvature, and perceived loss of penile length. Quality of life questionnaires into clinical practice might benefit some patients.