67th Annual Meeting Abstracts

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The Impact Of Preoperative Erectile Dysfunction On Survival After Radical Prostatectomy
Misop Han, *Bruce Trock, Alan Partin, *Elizabeth Humphreys, *Trinity Bivalacqua, *Thomas Guzzo, Patrick C Walsh
Johns Hopkins University, Baltimore, MD

Introduction: Erectile dysfunction (ED) and cardiovascular disease share etiology and pathophysiology. Preoperative ED may adversely affect survival following radical prostatectomy (RP). We examined the association between preoperative ED and survival following RP.
Materials & Methods: Between 1983 and 2004, a single surgeon performed RP on 2,515 men, with preoperative ED (ED group, n=234) or without ED (No ED group, n= 2,281). We retrospectively analyzed their prostate cancer-specific survival (PCSS), non-PCSS (NPCSS) and overall survival (OS) from time of surgery.
Results: With median follow-up of 12 years after prostatectomy, 450 men (18%) died (140 from prostate cancer, 310 from other causes). Kaplan-Meier analyses demonstrated significant differences in both NPCSS (p<0.001) and OS (p<0.001), but not in PCSS (p=0.18), between ED group vs. No ED group. In univariate proportional hazards analyses, preoperative ED was associated with a significant decrease in NPCSS, hazard ratio [HR], 0.52 (95% confidence interval [CI], 0.38-0.70), p<0.001, and in OS, HR, 0.58 (95% CI, 0.45-0.74), p<0.001. However, in multivariate analyses, the effect of ED on NPCSS and OS became insignificant after adjusting for other prognostic factors, such as age, PSA, Gleason score, pathologic stage, body mass index (BMI), and Comorbidity.

Conclusions: Men with preoperative ED experience significant decrease in NPCSS and OS following RP. However, preoperative ED is not an independent predictor of survival after adjusting for other predictors of survival following RP.

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