(773) Development and Validation of a Prediction Model for Erectile Dysfunction in Patients With Benign Prostatic Hyperplasia

Introduction Erectile dysfunction (ED) is a common comorbidity in males with benign prostatic hyperplasia (BPH). However, the risk factors for ED in patients with benign BPH are unclear. Objective To explore the risk factors for ED in patients with benign BPH and to develop and validate a predictive model for the occurrence of ED. Methods We prospectively selected patients who visited our hospital due to BPH from June 2023 to September 2024 as research subjects. These patients were divided into a simple BPH group and a BPH with ED group, and clinical characteristics were compared between the two groups of patients. Logistic regression analysis was employed to identify the risk factors for ED in patients with BPH and a nomogram risk prediction model was constructed. Internal validation was performed using the bootstrap method, with 1000 resamplings. The predictive efficacy was evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis. Results A total of 211 patients aged (67.9±8.7) years were included in the study, with 71 cases (33.6%)in the simple BPH group and 140 cases(66.4%)in the BPH with ED group. The BPH with ED group demonstrated significantly higher values in age, alcohol consumption, duration of BPH, prostate specific antigen (PSA) level, pulse pressure index, International Prostate Symptom Score (IPSS), Quality of Life (QoL) score,and Patient Health Questionnaire-9 (PHQ-9) core compared to the simple BPH group (all P<0.05). Conversely, body mass index (BMI) and serum total testosterone level were significantly lower in the BPH with ED group (all P<0.05). Multivariable logistic regression analysis revealed that age≥55 years [Using the<55 years group as the reference,the OR(95%CI for the≥55 to<65 years,≥65 to<75 years, and≥75 years groups were 7.575(95%Cl:1.128-33.210), 21.951(95%Cl:5.207-92.547), and 36.345(95%CI:7.494-176.345), respectively.], pulse pressure index≥0.4 (0R=3.159,95%Cl:1.482-6.731), serum total testosterone level<12 nmol/L (OR=3.427,95%Cl:1.638-7.172), and depressive status (OR=4.360,95%Cl:1.802-10.550) were risk factors for predicting ED (all P<0.05).The ROC curve indicated that the model had strong predictive performance,with an area under the curve (AUC) of 0.827(95%Cl:0.766-0.888).The slope of the calibration curve for the nomogram model was close to 1,indicating good fit (x2=7.893,P=0.444). Within a risk threshold range of 15%-95%,the nomogram model provided a clinically meaningful net benefit for predicting the risk of ED in BPH patients. Conclusions Age≥55 years, pulse pressure index≥0.4, serum total testosterone level<12 nmol/L, and depressive status are risk factors for ED in patients with BPH. The nomogram risk prediction model constructed based on the four risk factors demonstrates an excellent predictive performance. Disclosure No