REVIEW: Utilization of Pharmacotherapy for Erectile Dysfunction Following Treatment for Prostate Cancer |
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| Authors: | Michaella M Prasad Sandip M Prasad Nathanael D Hevelone Xiangmei Gu Aaron C Weinberg Stuart R Lipsitz Ganesh S Palapattu Jim C Hu |
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| Institution: | 1. Brigham and Women''s Hospital—Division of Urologic Surgery, Boston, MA, USA;;2. Brigham and Women''s Hospital—Center for Surgery and Public Health, Boston, MA, USA;;3. The Methodist Hospital—Department of Urology, Houston, TX, USA;;4. Dana-Farber Cancer Institute—Lank Center for Genitourinary Oncology, Boston, MA, USA;2. Department of Molecular Medicine, Section of Microbiology and Medical Biotechnologies, University of Padova, Padova, Italy;2. Rush University School of Medicine, Rush University Medical Center, IL, USA |
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| Abstract: | IntroductionPharmacotherapies improve sexual function following treatments for localized prostate cancer; however, patterns of care remain unknown.AimTo ascertain post-treatment utilization of pharmacotherapies for erectile dysfunction (ED) using a population-based approach.MethodsWe identified 38,958 men who underwent definitive treatment for localized prostate cancer during 2003–2006 from the MarketScan Medstat data.Main Outcome MeasuresWe compared the use of ED pharmacotherapy at baseline (up to 3 months prior) and up to 30 months following radical prostatectomy (RP) or radiotherapy (RT) for localized prostate cancer by utilizing National Drug Classification codes for phosphodiesterase-5 inhibitors (PDE5I), intracavernosal injectable therapies (IT), urethral suppositories and vacuum erection devices (VED). In adjusted analyses, we controlled for the effect of age, comorbidity, type of treatment, health plan and use of adjuvant hormone therapy on the use of pharmacotherapies.ResultsMen undergoing RP vs. RT were younger with less co-morbid conditions. Utilization of PDE5I was up to three times greater for men undergoing RP vs. RT, 25.6% vs. 8.8%, (P < 0.0001) in the first post-treatment year, and usage of these agents was greatest for men undergoing minimally-invasive RP procedures. A higher percentage of men also used IT, suppositories and VED after RP vs. RT (P < 0.001). However, more men in the RT group received adjuvant hormonal therapy (39.53% vs. 5.25% for RP, P < 0.01). In adjusted analyses, men undergoing RP vs. RT were more than two times likely (OR 2.1, 95% CI 1.98, 2.26) to use PDE5I post-treatment while men on adjuvant hormonal therapy were less likely to use PDE5I (OR 0.74, 95% CI 0.70–0.79, P < 0.0001).ConclusionMen undergoing RP vs. RT, particularly minimally-invasive RP, are more likely to employ IT, suppositories, VED, and PDE5I pharmacotherapy post-treatment. Prasad MM, Prasad SM, Hevlone ND, Gu X, Weinberg AC, Lipsitz SR, Palapattu GS, and Hu JC. Utilization of pharmacotherapy for erectile dysfunction following treatment for prostate cancer. |
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