Prebay Zachary J, Fu David, Hochberg Aaron R, Chung Paul H
Department of Urology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
Int J Impot Res. 2025 Jan 29. doi: 10.1038/s41443-025-01015-8.
Prostate cancer treatment-related erectile dysfunction and stress urinary incontinence are commonly treated with inflatable penile prosthesis (IPP) or artificial urinary sphincter (AUS). Given the association with androgens and penile/urethral health, we aim to evaluate whether patients on androgen deprivation therapy (ADT) undergoing IPP or AUS surgery are at increased risk for reintervention, complication, or infection. We queried the TriNetX database for adult males receiving IPP or AUS. The ADT cohort included those on ADT 3 months before or any time after surgery. We performed sub-analysis for leuprolide and bicalutamide. Cohorts and outcomes were defined by Current Procedural Terminology and International Classification of Diseases codes. Propensity score matching was performed using age, prostate cancer, history of prostatectomy, and history of radiation. Outcomes were reintervention (revision, removal, or replacement), infection, and complication. Analytics were performed in March 2024. 13,432 patients received an IPP and 5676 received an AUS, 465 and 745 of whom were on ADT, respectively. The only significant AUS analysis was for patients on abiraterone having fewer reinterventions (10.5% vs 20.8%, RR = 0.50 [0.29, 0.88]). Patients receiving an IPP with ADT had fewer reinterventions (7.2% vs 12%, RR = 0.60 [0.39, 0.92]) and complications (12.7% vs 18.5%, RR = 0.68 [0.49, 0.95]). Those on a GnRH agonist had fewer reinterventions (7.4% vs 11.7%, RR = 0.63 [0.41, 0.98]) for IPP. Patients receiving an IPP on bicalutamide had fewer reinterventions ( <5.2%* vs 10.8%, RR = 0.48 [0.23, 0.99]) and on leuprolide had fewer complications (12.2% vs 19.3%, RR = 0.63 [0.43, 0.91]). The remainder of analyses showed no significant differences. Patients with IPP or AUS do not fare worse on ADT. Further evaluation into the duration of ADT may provide clinical context, but based on these results, ADT should not limit implant surgery.
前列腺癌治疗相关的勃起功能障碍和压力性尿失禁通常采用可膨胀阴茎假体（IPP）或人工尿道括约肌（AUS）进行治疗。鉴于雄激素与阴茎/尿道健康之间的关联，我们旨在评估接受IPP或AUS手术的雄激素剥夺治疗（ADT）患者再次干预、并发症或感染的风险是否增加。我们在TriNetX数据库中查询接受IPP或AUS的成年男性。ADT队列包括手术前3个月或手术后任何时间接受ADT的患者。我们对亮丙瑞林和比卡鲁胺进行了亚组分析。队列和结局由当前手术操作术语和国际疾病分类代码定义。使用年龄、前列腺癌、前列腺切除术史和放疗史进行倾向评分匹配。结局指标为再次干预（翻修、移除或更换）、感染和并发症。分析于2024年3月进行。13432例患者接受了IPP，5676例接受了AUS，其中分别有465例和745例接受ADT。唯一有显著差异的AUS分析是接受阿比特龙治疗的患者再次干预较少（10.5%对20.8%，RR = 0.50 [0.29, 0.88]）。接受IPP且同时接受ADT的患者再次干预较少（7.2%对12%，RR = 0.60 [0.39, 0.92]），并发症也较少（12.7%对18.5%，RR = 0.68 [0.49, 0.95]）。使用GnRH激动剂的患者接受IPP时再次干预较少（7.4%对11.7%，RR = 0.63 [0.41, 0.98]）。接受比卡鲁胺治疗的患者接受IPP时再次干预较少（<5.2%*对10.8%，RR = 0.48 [0.23, 0.99]），接受亮丙瑞林治疗的患者并发症较少（12.2%对19.3%，RR = 0.63 [0.43, 0.91]）。其余分析未显示显著差异。接受IPP或AUS的患者在ADT治疗下预后并不更差。对ADT持续时间的进一步评估可能会提供临床背景信息，但基于这些结果，ADT不应限制植入手术。
此处<5.2%标注可能是原文中该数据有特殊说明或标记，保留原文形式未翻译具体含义
