(061) Penile Prosthesis Implantation Associated With Discontinuation of Depression and Anxiety Prescriptions

Abstract Introduction Depression and anxiety are prevalent among men with erectile dysfunction. Prior work using validated psychological heath questionnaires showed an association between treatment of erectile dysfunction using an implantable penile prosthesis and relief from depression symptoms. Because the number of patients with this questionnaire data was limited, we assessed depression/anxiety medication prescription data as a surrogate. Objective To longitudinally assess prescriptions of medication to address depression and anxiety in the year prior to and the year following a penile prosthesis implantation. Methods This study utilized a retrospective cohort of electronic health records data compiled by Truveta from a collective of U.S. healthcare systems. The analysis included males receiving an initial penile prosthesis implant (2011-2024) who were prescribed an anti-depressant or anti-anxiety medication within the prior year. Counts and proportions along with the 95% confidence interval were used to summarize the categorical variables. Results We identified 597 men who received medication prescriptions for depression and/or anxiety in the year prior to their penile prosthesis implant. These patients had a mean age of 64.6, 52% were married, and 32% had a history of prostate cancer. In the year after the penile prosthesis implant, 39.2% (95% CI: 35.3%–43.1%) of these patients discontinued their depression / anxiety medication prescriptions. Subset analyses align with this result. Of the subset of n=115 patients with their pre-implant medication attached to an International Classification of Disease (ICD) diagnosis code for depression or anxiety, 27.0% (95% CI: 18.9%–35.1%) discontinued their prescriptions post-implant. Of the subset of n=78 patients with a pre-implant prescription and depression / anxiety questionnaires, 62.8% report their post-implant symptoms as ‘none’ or ‘mild’, compared to 38.5% pre-implant (McNemar’s p<0.01). Figure 1 shows that the reduction in medication prescriptions applies for each of the major drug classes assessed (n=597), selective serotonin reuptake inhibitors (SSRI), benzodiazepine, serotonin-norepinephrine reuptake inhibitors (SNRI), serotonin antagonist and reuptake inhibitors (SARI), norepinephrine-dopamine reuptake inhibitors (NDRI), tricyclic antidepressants (TCA), tetracyclic antidepressants (TeCa). Conclusions A de novo penile prosthesis implantation is associated with discontinuation of depression/anxiety medication prescriptions. These data support previously observed real world evidence from validated psychological assessments, which demonstrated an association between a penile prosthesis implant and relief from depression. The results emphasize the importance of screening for depression and anxiety among patients suffering from erectile dysfunction. Disclosure Yes, this is sponsored by industry/sponsor: Boston Scientific Corporation. Clarification: Industry initiated, executed and funded study Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific Corporation.