title: Penile implant utilization following treatment for prostate cancer: analysis of the SEER-Medicare database.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Sexual and Reproductive Medicine Program, Urology Service, Department of Surgery, New York, NY 10065, USA.
authors.forename: Raanan
authors.initials: R
authors.lastname: Tal
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Jacks
authors.forename: Elena
authors.initials: E
authors.lastname: Elkin
authors.forename: John P
authors.initials: JP
authors.lastname: Mulhall
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003131:Combined Modality Therapy; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D015917:Penile Prosthesis / Q000706:statistics & numerical data*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D011878:Radiotherapy; D018426:SEER Program; D014600:Utilization Review / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data