PII-LBA6 EFFECT OF TESTOSTERONE SOLUTION ON TOTAL TESTOSTERONE, SEX DRIVE AND ENERGY IN HYPOGONADAL MEN

replaced open radical prostatectomy (RRP) despite equivocal evidence of superiority. Most available data are from single surgeon/ center reports, lack adequate risk-adjustment and/or use limited information on patient-reported outcomes. The goal of this study was to use population-based data to compare patient-reported sexual and urinary quality of life (QOL) outcomes following RRP and RALP. METHODS: We used data from Prostate Cancer Outcomes Study (PCOS) and Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR), which are both large population-based, prospective cohort studies. All men in PCOS underwent RRP from 1994-1995, and the majority (78.1%) in CEASAR underwent RALP from 2011-2012 with the minority undergoing RRP (21.9%). QOL was measured by the UCLA Prostate Cancer Index in PCOS and the Expanded Prostate Cancer Index Composite-26 in CEASAR. To reduce differences in these tools, we used 4 common measures of urinary incontinence and 3 of sexual function and derived modified domain summary scores scaled 0100, with 100 indicating ideal function. Between group differences were assessed at 6 and 12 months after surgery with multivariable linear regression model-based contrast tests using t-statistics. Models included interaction terms between baseline QOL and procedure type (RALP vs RRP) and adjusted for sociodemographic and clinical factors. RESULTS: The cohort included 2438 men, 1505 that underwent RRP (1243 PCOS and 262 CEASAR) and 933 that underwent RALP (CEASAR only). In men with excellent baseline urinary function (score1⁄4100), those undergoing RALP had better scores at 6 months (3.8 points, 95% CI 1.1 e 6.4) but not at 12 months (1.2 pts, 95% CI -1.3 e 3.7). Among men with excellent baseline sexual function (score 1⁄4 100), patients undergoing RALP had higher scores at 6 months (10.2 pts, 95% CI 7.5 e 12.9) and 12 months (10.3 pts, 95% CI 7.5 e 13.1). Among men with low baseline sexual function (score1⁄465), RALP was favored to a lesser extent with 5.2 (95% CI 2.8 e 7.6) and 3.3 points (95% CI 0.8 e 5.8) higher at 6 and 12 months. CONCLUSIONS: This population-based study using validated and reliable QOL tools suggests benefit of RALP. Alternatively, differences could reflect consolidation of prostatectomies at high volume centers or standardization of technique during the CEASAR era. Longer follow-up is required to establish whether benefits persist beyond one year and to assess for differences in oncologic outcomes. Source of Funding: This study was supported by the US Agency for Healthcare Research and Quality (grants 1R01HS019356 and 1R01HS022640-01); the National Cancer Institute, National Institutes of Health (grant R01-CA114524), and the following contracts from the each of the participating institutions: N01-PC67007, N01-PC-67009, N01-PC-67010, N01-PC-67006, N01PC-67005, and N01-PC-67000, and through a contract from the Patient-Centered Outcomes Research Institute.