Roni M Joentausta, Aino Siltari, Antti Rannikko, Teemu J Murtola
{"title":"芬兰全国队列研究中,他汀类药物治疗根治性前列腺切除术后勃起功能障碍的发生率。","authors":"Roni M Joentausta, Aino Siltari, Antti Rannikko, Teemu J Murtola","doi":"10.1080/21681805.2023.2168746","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Erectile dysfunction (ED) is common after radical prostatectomy (RP) due to cavernous nerve damage. Risk of ED is also affected by vascular function. Statins prevent vascular events but their association with post-prostatectomy ED is unclear. We explored the likelihood of starting ED treatment after RP by statin use at the population level.</p><p><strong>Methods: </strong>The study cohort included 14,295 prostate cancer (PCa) patients with no ED treatment prior to diagnosis of PCa treated with RP in Finland during 1995-2013. Information on use of cholesterol-lowering drugs and ED medication during 1995-2014 and penile prosthesis implantation during 1996-2014 were gathered from national registries. Risk of ED treatment initiation after RP was analyzed by pre-diagnostic and post-diagnostic statin and non-statin cholesterol lowering (NSCL) drug use with Cox regression model.</p><p><strong>Results: </strong>Pre-diagnostic statin use or NSCL drug use overall had no association with risk of ED treatment initiation after RP. Post-diagnostic statin use was associated with a slightly increased risk of initiation of any ED treatment (HR = 1.07; 95% CI = 1.01-1.14). Patients with the longest duration of post-diagnostic statin use had a significantly decreased risk of PDE5 inhibitor initiation compared to non-users (HR = 0.43; 95% CI = 0.20-0.94). Among patients with no cardiovascular comorbidities, pre-diagnostic statin users had a significantly increased risk of initiation of injectable ED drugs (HR = 1.27; 95% CI = 1.04-1.55), however, no association with risk of any other ED treatment was observed.</p><p><strong>Conclusion: </strong>Statin users have a slightly increased risk of ED treatment initiation after RP, which probably reflects the effect of the underlying vascular insufficiency.</p>","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"57 1-6","pages":"53-59"},"PeriodicalIF":1.4000,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Incidence of erectile dysfunction treatment after radical prostatectomy by Statin use in Finnish Nationwide Cohort Study.\",\"authors\":\"Roni M Joentausta, Aino Siltari, Antti Rannikko, Teemu J Murtola\",\"doi\":\"10.1080/21681805.2023.2168746\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Erectile dysfunction (ED) is common after radical prostatectomy (RP) due to cavernous nerve damage. Risk of ED is also affected by vascular function. Statins prevent vascular events but their association with post-prostatectomy ED is unclear. We explored the likelihood of starting ED treatment after RP by statin use at the population level.</p><p><strong>Methods: </strong>The study cohort included 14,295 prostate cancer (PCa) patients with no ED treatment prior to diagnosis of PCa treated with RP in Finland during 1995-2013. Information on use of cholesterol-lowering drugs and ED medication during 1995-2014 and penile prosthesis implantation during 1996-2014 were gathered from national registries. Risk of ED treatment initiation after RP was analyzed by pre-diagnostic and post-diagnostic statin and non-statin cholesterol lowering (NSCL) drug use with Cox regression model.</p><p><strong>Results: </strong>Pre-diagnostic statin use or NSCL drug use overall had no association with risk of ED treatment initiation after RP. Post-diagnostic statin use was associated with a slightly increased risk of initiation of any ED treatment (HR = 1.07; 95% CI = 1.01-1.14). Patients with the longest duration of post-diagnostic statin use had a significantly decreased risk of PDE5 inhibitor initiation compared to non-users (HR = 0.43; 95% CI = 0.20-0.94). 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引用次数: 0
摘要
背景:根治性前列腺切除术(RP)后由于海绵状神经损伤而出现勃起功能障碍(ED)是很常见的。ED的风险也受血管功能的影响。他汀类药物可预防血管事件,但其与前列腺切除术后ED的关系尚不清楚。我们在人群水平上探讨了RP后使用他汀类药物开始ED治疗的可能性。方法:研究队列包括1995-2013年芬兰14295例前列腺癌(PCa)患者,在诊断为前列腺癌之前未接受ED治疗,并接受RP治疗。从国家登记处收集1995-2014年期间降胆固醇药物和ED药物的使用信息以及1996-2014年期间阴茎假体植入的信息。通过诊断前和诊断后他汀类和非他汀类降胆固醇药物(NSCL)的使用,采用Cox回归模型分析RP后ED开始治疗的风险。结果:诊断前使用他汀类药物或非小细胞肺癌药物总体上与RP后开始ED治疗的风险无关。诊断后使用他汀类药物与开始任何ED治疗的风险略有增加相关(HR = 1.07;95% ci = 1.01-1.14)。诊断后使用他汀类药物时间最长的患者与未使用他汀类药物的患者相比,PDE5抑制剂启动的风险显著降低(HR = 0.43;95% ci = 0.20-0.94)。在没有心血管合并症的患者中,诊断前他汀类药物使用者开始注射ED药物的风险显著增加(HR = 1.27;95% CI = 1.04-1.55),然而,没有观察到与任何其他ED治疗的风险相关。结论:他汀类药物使用者在RP后开始ED治疗的风险略有增加,这可能反映了潜在血管功能不全的影响。
Incidence of erectile dysfunction treatment after radical prostatectomy by Statin use in Finnish Nationwide Cohort Study.
Background: Erectile dysfunction (ED) is common after radical prostatectomy (RP) due to cavernous nerve damage. Risk of ED is also affected by vascular function. Statins prevent vascular events but their association with post-prostatectomy ED is unclear. We explored the likelihood of starting ED treatment after RP by statin use at the population level.
Methods: The study cohort included 14,295 prostate cancer (PCa) patients with no ED treatment prior to diagnosis of PCa treated with RP in Finland during 1995-2013. Information on use of cholesterol-lowering drugs and ED medication during 1995-2014 and penile prosthesis implantation during 1996-2014 were gathered from national registries. Risk of ED treatment initiation after RP was analyzed by pre-diagnostic and post-diagnostic statin and non-statin cholesterol lowering (NSCL) drug use with Cox regression model.
Results: Pre-diagnostic statin use or NSCL drug use overall had no association with risk of ED treatment initiation after RP. Post-diagnostic statin use was associated with a slightly increased risk of initiation of any ED treatment (HR = 1.07; 95% CI = 1.01-1.14). Patients with the longest duration of post-diagnostic statin use had a significantly decreased risk of PDE5 inhibitor initiation compared to non-users (HR = 0.43; 95% CI = 0.20-0.94). Among patients with no cardiovascular comorbidities, pre-diagnostic statin users had a significantly increased risk of initiation of injectable ED drugs (HR = 1.27; 95% CI = 1.04-1.55), however, no association with risk of any other ED treatment was observed.
Conclusion: Statin users have a slightly increased risk of ED treatment initiation after RP, which probably reflects the effect of the underlying vascular insufficiency.
期刊介绍:
Scandinavian Journal of Urology is a journal for the clinical urologist and publishes papers within all fields in clinical urology. Experimental papers related to clinical questions are also invited.Important reports with great news value are published promptly.