Penile Implant Utilization Following Treatment for Prostate Cancer: Analysis of the SEER-Medicare Database

Authors

  • Raanan Tal MD,

    1. Sexual and Reproductive Medicine Program, Urology Service, Department of Surgery, New York, NY, USA
    Search for more papers by this author
  • Lindsay M. Jacks MSc,

    1. Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
    Search for more papers by this author
  • Elena Elkin PhD,

    1. Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
    Search for more papers by this author
  • John P. Mulhall MD

    Corresponding author
    1. Sexual and Reproductive Medicine Program, Urology Service, Department of Surgery, New York, NY, USA
      John P. Mulhall, MD, Sexual and Reproductive Medicine Program, Urology Service, Department of Surgery, 353 E 68th St, New York, NY 10065, USA. Tel: 646-422-4359; Fax: 212-988-0768; E-mail: mulhalj1@mskcc.org
    Search for more papers by this author

John P. Mulhall, MD, Sexual and Reproductive Medicine Program, Urology Service, Department of Surgery, 353 E 68th St, New York, NY 10065, USA. Tel: 646-422-4359; Fax: 212-988-0768; E-mail: mulhalj1@mskcc.org

ABSTRACT

Introduction.  Prostate cancer treatments, including radical prostatectomy (RP) and radiotherapy (RT), may adversely affect erectile function. Penile implant surgery is a well-recognized erectile dysfunction (ED) treatment for prostate cancer survivors who wish to remain sexually active and in whom nonsurgical treatments are ineffective or unpalatable.

Aim.  To describe the utilization of penile implants after RP or RT for prostate cancer and to identify predictors of such use.

Methods.  From Surveillance Epidemiology and End Results cancer registry data linked with Medicare claims, we identified men aged ≥66 years diagnosed with prostate cancer in 1998–2005 who were treated with RP or RT. Utilization of penile implants was identified in Medicare claims. Multivariable logistic regression was used to identify demographic and clinical predictors of implant utilization.

Main Outcome Measures.  Medicare claim for penile implant surgery, impact of demographic and clinical factors on penile implant surgery utilization.

Results.  The study group comprised 68,558 subjects, including 52,747 who had RT and 15,811 who had RP as primary prostate cancer treatment. The penile implant utilization rate was 0.8% for the entire group, 0.3% for the RT group, and 2.3% for the RP group. Predictors of penile implant utilization were initial treatment modality, younger age, and African American or Hispanic race, being unmarried and residing in the South or West.

Conclusions.  Penile implant utilization after prostate cancer treatment is relatively uncommon in men over 65. Men who are younger, African American or Hispanic, and those who have an RP are more likely than their peers to receive a penile implant after prostate cancer treatment. Tal R, Jacks LM, Elkin E, and Mulhall JP. Penile implant utilization following treatment for prostate cancer: Analysis of the SEER-Medicare database. J Sex Med 2011;8:1797–1804.

Ancillary