(004) Retrospective Concomitant Nonrandomized Comparison of Testosterone Replacement Therapy Versus No Treatment for Erectile Function Post Radical Prostatectomy

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Abstract Introduction Recent studies have shown that testosterone replacement therapy (TRT) can be safely applied in men with low-risk prostate cancer. Objective To assess TRT versus no TRT 2-year potency outcomes in hypogonadal men aged ≥ 60. Methods Retrospective concomitant nonrandomized comparison of 70 hypogonadal men, aged 60 or older, were stratified by TRT post-RP. Baseline demographics, total testosterone (TT) calculated free testosterone (cFT), and comorbidities prior to RP were measured from October 2016 – October 2020. Sexual function was assessed via the International Index of Erectile Function (IIEF-5) pre-and post-surgery. Potency (evaluated at 3-, 9-, 15-, and 24-months post-RP) was defined as erections sufficient for penetration and satisfying, and/or erection fullness >75%, and/or a score of 5 on Q1 (IIEF-5; confidence). T-tests, chi-square, and regression analyses were performed. Results Potency at 2 years was 63.6% (TRT) versus 35.1% (No TRT; p=0.017). Regression analysis showed that TRT was a predictor of potency outcomes 2 years post-RP (OR: 3.33; 95% CI: 1.16–10.3; p=0.029) after adjusting for age and Gleason Grade Group. There were no statistically significant differences in baseline factors between the TRT-receiving and no-TRT groups. BCR rates between the two groups were 12.1% (TRT) versus 27.0% (no TRT; p=0.12) with a mean follow-up time of 40.2 ± 13.6 months. Kaplan Meier analysis demonstrated a trend toward a significant difference in time to BCR (p=0.078). Conclusions In hypogonadal men aged ≥ 60, TRT significantly improved potency outcomes 2-years post-RP. The risk of BCR overall in men receiving TRT was lower but not statistically significant. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: FY – Advisory board and speaker for Coloplast; consultant for Cynosure; advisory board and speaker for Halozyme; intellectual property with Masimo; advisory board for Promescent; consultant for Sprout; advisory board for Xialla.

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