DOI: 10.1093/jsxmed/qdae001.272 ISSN: 1743-6095

(285) Evaluation of Penile Prosthesis Implantation in Older Adults with Bladder Cancer After Radical Cystectomy

A Abello, S Kaul, A Fleishman, A Morgenthaler, R Korets, P Chang, A Wagner, S Kim, A Olumi, B Gershman
  • Urology
  • Reproductive Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health



Erectile dysfunction (ED) is common after radical cystectomy (RC), but ED treatment in this setting remain understudied. Many such patients will be unresponsive to oral pharmacotherapy, often requiring penile prosthesis (PP) implantation.


The objective of this study was to evaluate PP implantation in a contemporary, national cohort of older adults with bladder cancer following RC.


We used the SEER-Medicare database to identify male patients 66 years and older diagnosed with Tany Nany M0 bladder cancer from 2000 to 2017 and treated with RC. We estimated time to PP implantation using the Kaplan-Meier method, and evaluated the associations of baseline characteristics with PP implantation using Cox proportional hazard regression.


The study cohort included 4,468 men who underwent RC, including 75% who were married or had a domestic partner. A total of 334 (7%) patients had baseline ED. Median follow-up after RC was 38.0 (IQR 16.0-84.0) months. After RC, only 71 (2%) patients underwent PP implantation, with a median time to PP implantation of 12 (IQR 5-32) months. In univariable analysis, younger age, black race, and undergoing RC at small bed size hospitals, comprehensive NCI Cancer Centers, higher RC volume hospitals, and hospitals in the West and South/Southeast regions were associated with higher rates of implantation (Table 1). Disease characteristics were not related to PP implantation.


Despite the expected prevalence of ED following RC, contemporary, real-world rates of PP implantation are very low. Univariable analyses suggest that both patient characteristics and features of the hospital performing RC are associated with treatment for post-RC ED with PP implantation.



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