Pd32-03 Characterizing Corporovenocclusive Dysfunction in Men After Radiation Therapy for Prostate Cancer

You have accessJournal of UrologySexual Function/Dysfunction: Evaluation II (PD32)1 May 2024PD32-03 CHARACTERIZING CORPOROVENOCCLUSIVE DYSFUNCTION IN MEN AFTER RADIATION THERAPY FOR PROSTATE CANCER Ahmed Elshafei, Nicole Liso, John P. Mulhall, and Jose M. Flores Ahmed ElshafeiAhmed Elshafei , Nicole LisoNicole Liso , John P. MulhallJohn P. Mulhall , and Jose M. FloresJose M. Flores View All Author Informationhttps://doi.org/10.1097/01.JU.0001009364.27111.54.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radiation therapy (RT) for prostate cancer (PC) often leads to erectile dysfunction (ED). We aimed to characterize corporvenocclusive dysfunction (CVOD) rates in men following RT for PC. METHODS: Study population consisted of (i) men after RT with or without androgen deprivation therapy (ADT) (ii) who developed ED (iii) with poor response to PDE5i and ICI, (iv) who had penile duplex Doppler ultrasound (DUS) (v) using a vasoactive agent redosing schedule. Arterial insufficiency (AI) was defined using a peak systolic velocity (PSV) <30 cm/sec bilaterally and CVOD using end diastolic velocity (EDV) values≥5 cm/sec bilaterally. Demographics, comorbidity, endocrine profiles, and DUS parameters were recorded. The erection hardness scale (EHS) was used to evaluate ED before RT (1-4, 4 hardest erection). We used univariate and multivariable analysis (MV) to define factors predictive of CVOD. Variables included age, comorbid conditions (diabetes (DM), hyperlipidemia (HLD), obstructive sleep apnea (OSA), coronary artery disease (CAD), hypertension (HTN)), RT type (brachy vs. external beam), RT dose, EHS, and ADT duration. Factors included in MVA model: patient age, comorbidities, and ADT exposure duration. RESULTS: 156 men were analyzed. Median age was 69 (62, 74) years. Median RT dose 7020 (4000, 10000) Gy with 57% of men received External beam RT and 43% received Brachytherapy RT. 54% received ADT, with a median exposure of 15 (6, 24) months .33% received ADT for≥12 months. 4% had≥3 vascular comorbidities: DM 21%, OSA 25%, cigarette smoking 47%. Median pre-RT EHS score 4 (3,4) , 20% of the men had an erection less than penetration rigidity. Median baseline PSA and pre-RT total testosterone (T) were 3.5 (0.4, 6) ng/mL, 14 (8, 313) ng/dL. Median total T at the time of DUS was 350 (207, 457) ng/dL and 46% had low T. Median trimix dose administered at DUS was 75 (20, 100) units. 50% received 100 units. Median PSV was 43 (33, 56) cm/sec, median EDV 8 (0, 12) cm/sec. Erection reversal occurred in 36% of the cases. CVOD was diagnosed in 59%. AI was diagnosed in 14%, CVOD+AI was observed in 7% of cases. On MV, the predictors of CVOD were older age, ADT duration≥12 months, dyslipidemia (Table 1). CONCLUSIONS: In men after RT for PC, CVOD was present in more than half of patients studied. Age, duration of ADT exposure and dyslipidemia were predictors of CVOD development. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e704 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Ahmed Elshafei More articles by this author Nicole Liso More articles by this author John P. Mulhall More articles by this author Jose M. Flores More articles by this author Expand All Advertisement PDF downloadLoading ...