Landon Trost

MP84-04 PREDICTION OF FUTURE ERECTILE DYSFUNCTION USING COMORBID DISEASE AND MEDICATION PROFILES

by three observers at different time points, each being blinded to the goniometer assessment. The primary outcome was to compare the inter-observer and intra-observer reliability of GoSoft. We also aimed to compare the concordance between GoSoft and goniometry. We compare correlation for curvature 45 degrees and for > 45 degrees. We accepted a variability of 5 degrees and considered an under and over-estimation if the difference was >5 degrees. RESULTS: 53 subjects were included. The intra-observer reliability was excellent, representing a high correlation ( r1⁄40.96 to 0.98, p<0.001) with a variance between means of 1.3 0.6 degrees. The inter-observer reliability was also high (r1⁄40.89 to 0.95, p<0.001) (Figure 1) with a variance between means of 2.2 1 degrees. The Pearson correlation coefficients (r) between the goniometer and GoSoft for each rater were: Rater 1: r1⁄40.75, p<0.001; Rater 2: r1⁄40.73, p<0.001; and Rater 3: r1⁄40.80, p<0.001. This indicates strong agreement, but also suggests variability between the types of measurement. For the three raters, when comparing GoSoft to the goniometer, GoSoft accurately measured (within 5 degrees) 45% of the curvatures, underestimated it by >5 degrees in 25% of the curvatures, and overestimated it by >5 degrees in 30% of the curvatures. The correlation appears to be higher for greater curvatures. For curvature 45 degrees, the correlations between goniometer and GoSoft ranged from: r1⁄40.41-0.47, p1⁄40.03; while, for curvatures > 45 degrees, the correlations ranged from: r1⁄40.59-0.65, p<0.01. CONCLUSIONS: GoSoft assessment is consistent with goniometry. The excellent reliability and reproducibility might provide a more standardized instrument for CA in men with PD.

MP56-13 CLINICAL FACTORS NEGATIVELY IMPACTING SEXUAL RELATIONSHIPS IN MEN WITH PEYRONIE'S DISEASE

INTRODUCTION AND OBJECTIVES: Peyronie0s Disease (PD) is known to have a significant negative impact on the psychosocial and relationship functioning of male patients, with studies finding increased depression, distress, and sexual dysfunction in men with PD. In just the past year, researchers have also begun to attend to the female partners of these men, studying their own sexual function, relationship satisfaction, and mood. However, these few studies are flawed: by using the male patient as a gateway to access his female partner, they limit their access to women whose partners are comfortable making such a referral; by using surveys that emphasize sexual function, they restrict the opportunity for the partners to define their own concerns. This study seeks to address these problems, using narrative content analysis of Internet posts made by female PD partners to describe and rank the concerns expressed by these women, independent of their interactions with researchers and male partners. METHODS: This is a qualitative study, analyzing the content of Internet posts made by female PD partners on two patient-centered and member-operated, English-language PD support forums. In deference to ethical concerns regarding consent to research, only those posts within the public domain and readily accessible to non-members via Google search were analyzed. A Grounded theory process was used, with open coding to identify themes of concern. RESULTS: From 2/2005-10/2016, a total of 793 posts were published online, by 48 female PD partners. The primary concern expressed by these women related to difficulty communicating with their partners about PD, with 24/48 (50%) posting about this issue. Secondary concerns were partners0 emotional (18/48 (38%)) and physical (12/48 (25%)) pain. Only 10/48 (21%) expressed concern about their own diminished sexual pleasure, with 4/48 (8%) describing how their partners0 curvature enhanced their sexual experience. CONCLUSIONS: When evaluated through the nonintrusive method of Internet narrative analysis, female PD partners are most concerned with poor communication, followed by their partners0 emotional and physical pain. While their sexual needs do merit attention, this study suggests that interventions targeting the psychosocial needs of patients and their partners would be most meaningful for this population.

MP84-01 PREDICTORS OF INCREASED INTRACAVERNOSAL INJECTION REQUIREMENTS AT PENILE ULTRASOUND

INTRODUCTION AND OBJECTIVES: Penile duplex Doppler ultrasound (PDDU) with intracavernosal injection (ICI) with erectogenic agents is commonly used to evaluate vascular parameters in men with erectile dysfunction (ED). Recent studies have suggested significant variability in outcomes based on ICI dosing protocols, suggesting a need for standardization of injection protocols. Given a lack of literature on this topic, we sought to identify predictors for increased need of ICI dosing to achieve adequate rigidity at the time of PDDU. METHODS: A retrospective chart review was performed of all patients undergoing PDDU for evaluation of ED from January 2014 to November 2015. At the time of PDDU, men received a combination of papaverine(30 mg/mL), phentolamine(1 mg/mL), and alprostadil(10 mcg/mL) in 0.1 mL increments until an erection sufficient for penetration was achieved or 1.0 cc was administered. Clinicopathologic and demographic variables were reviewed, and univariate and multivariate analyses were used to identify characteristics associated with increased erectogenic requirements. RESULTS: A total of 262 men (mean age 53;) underwent PDDU during the study period. Mean IIEF-6 score was 12.4 (SD 10.2), and a mean 2.1 injections (SD 1.1) with 0.34 cc (SD 0.34) were administered. On multivariate analysis, lower IIEF-ED domain score (p<0.01), coronary disease (p1⁄40.03), and diabetes (p1⁄40.01) were associated with increased requirement for erectogenic medications. CONCLUSIONS: Patients with lower IIEF scores, coronary disease, and diabetes mellitus may require higher volumes of erectogenic medications at the time of PDDU. This information may help to create standardized and efficient protocols for repeated dosing regimen.

MP84-13 RISK FACTORS FOR ERECTILE DYSFUNCTION IN A POPULATION BASED COHORT

CONCLUSIONS: Only CFT and T:E ratio were predictive of positive libido response on IIEF11 & 12 questionnaire in our cohort. Estradiol, even at a cutoff of 5 ng/dL, was not independently associated with improved libido. Surprisingly total testosterone did not associate with IIEF11 (desire frequency). The effect of testosterone and estradiol administration on libido requires further prospective study.

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.