Page 4 - CUA2018 Abstracts - LUTS

Poster session 3: Male LUts/Men’s Health

Introduction: Masculine ideals and norms can encourage men’s risky Conclusions: In this cohort of patients presenting to an andrology clinic,
health behaviours and limit their health–promoting practices, leading to marijuana users had statistically significantly higher serum testosterone
preventable morbidity and mortality. Our aim was to evaluate a broad levels and SHIM scores, were more likely to report positive ADAM scores,
range of health behaviours and construct a total health behaviour classifi- and were less likely to report SHIM scores <21. In addition, marijuana users
cation, as a means to making recommendations for targeted interventions. engage in sexual intercourse more frequently. However, these differences
Methods: Men completed a 15–minute online survey, querying their are unlikely to be clinically significant. This study fails to demonstrate
demographics and five health behaviours: smoking, alcohol, sleep, a deleterious effect of marijuana consumption on male sexual function.
exercise, and diet, as well as depression, a surrogate for mental well– References:
being. Each behaviour was classified as a binary healthy or unhealthy 1. Gundersen TD, Jørgensen N, Andersson AM, et al. Association
outcome based upon a priori questionnaire thresholds. For our novel total between use of marijuana and male reproductive hormones and
health behaviour classification, men were considered very healthy if no semen quality: A study among 1215 healthy young men. Am J
unhealthy behaviours, healthy if 1/6 unhealthy behaviour, borderline with Epidemiol 2015;182:473–81. https://doi.org/10.1093/aje/kwv135
2/6, and unhealthy with 3–6/6 unhealthy behaviours. Multivariate logistic 2. Sun AJ, Eisenberg ML. Association between marijuana use and sex-
regression was performed to identify variables predictive of total health ual frequency in the United States: A population–based study. J Sex
behaviour classification (STATA). Med 2017;14:1342–7. https://doi.org/10.1016/j.jsxm.2017.09.005
Results: A total of 5360 participants visited the online survey page. After
examining sample stratification, inclusion and exclusion criteria, 2000 MP–3.12
Canadian men aged 19–94 completed the survey. Table 1 (available at
https://cua.guide/) demonstrates men distributed among the total health Access to penile prostheses differ significantly across provinces
classification. Multivariate analysis identified increased healthy behav- in Canada: A survey of Canadian urologists 2
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iours among older (p=0.001) and retired men (p=0.008), odds ratio (OR) Stewart Whalen , Gavin Langille , Gregory Bailly
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0.983 (95% confidence interval [CI] 0.973–0.993) and 0.635 (95% CI 2 Faculty of Medicine, Dalhousie University, Halifax, NS, Canada;
0.454–0.889), respectively. A positive trend for number of healthy behav- Department of Urology, Dalhousie University, Halifax, NS, Canada
iours was observed for men with higher income. Men with hypertension Introduction: Surgical implantation of a penile prosthesis is the gold
(OR 1.400; 1.100–1.786; p=0.007) and erectile dysfunction (OR1.923; standard treatment for refractory erectile dysfunction. The purpose of this
1.289–2.871; p=0.001) were associated with unhealthy behaviours. study was to evaluate access to these procedures in Canada.
Conclusions: An alarming half of Canadian men (47.4%) were classified Methods: Canadian urologists known to implant penile prostheses were
as unhealthy, with 3–6/6 unhealthy behaviours, affirming the need for surveyed on areas such as surgical volume, type of prostheses used, and
targeted interventions. Specifically, these findings reveal significant health the direct cost to patients for both malleable and inflatable devices.
inequities within subgroups of Canadian men and will guide the content Results: Of the 50 urologists invited to participate in this study, 34 (68%)
and delivery of precision/personalized communications. completed the survey. Participants represented nine of 10 Canadian prov-
inces and included a mix of academic (65%) and community (35%)
urologists. American Medical Systems (AMS) prostheses were used exclu-
MP–3.11 sively by 88% of participants, while 12% used both AMS and Coloplast
Marijuana use may not impact male sexual function or frequency: products. The majority (79%) performed less than 20 procedures per
Statistical significance as a smoke screen in sexual medicine year. Roughly three–quarters (74%) of participants used inflatable pros-
Jafar Hussean , Christopher Wallis , Keith Jarvi , Ethan Grober , Kirk Lo , theses in over 90% of cases, while half implanted inflatable prostheses
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Yonah Krakowsky 1 exclusively. Participants from Alberta, Manitoba, New Brunswick, and
1 Division of Urology, University of Toronto, Toronto, ON, Canada Newfoundland reported full coverage for both malleable and inflatable
Introduction: As marijuana becomes legal in many North American juris- prostheses. Saskatchewan was the only province participants reported
dictions, interest regarding its impact on sexual function has increased. having no coverage for either. Nova Scotia was found to have full coverage
Previous studies have demonstrated the deleterious effect of marijuana for malleable and partial coverage for inflatable prostheses. Participants
use on fertility. A recent, highly publicized study demonstrated that mari- from the remaining provinces of British Columbia, Ontario, and Quebec
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juana users have more frequent sexual activity than non–users. However, reported variable coverage based on healthcare centre. Across all centres
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there is limited evidence examining the impact of marijuana on male without full coverage, the mean reported cost to patients for malleable
sexual function. The following report explores the impact of marijuana and inflatable prostheses were $5100 and $6782, respectively.
on frequency of sexual activity, erectile function (via the Sexual Health Conclusions: Urologists surveyed perform primarily inflatable penile
Inventory for Men [SHIM]), hormonal profiles and Androgen Deficiency prostheses procedures with a preference for AMS products. Significant
in the Aging Male (ADAM) scores. geographical differences exist with respect to reported coverage for these
Methods: A retrospective cohort study was performed on an andrology procedures. This study highlights the need for continued advocacy on
database of 8879 male patients from a single academic centre between behalf of the urological community towards the goal of equity in cover-
2008 and 2017. Marijuana users and controls (non–users) were identi- age for penile prostheses across Canada.
fied and compared. Cases and controls were analyzed with regards to
hormonal profiles, SHIM scores, ADAM scores, and reported sexual fre- UP–3.1
quency. Simple t–test and Chi–square square analyses were performed
to assess the statistical significance of our findings. Top–down holmium laser enucleation of the prostate: Initial
Results: Of 8879 study subjects, 1103 (12.4%) marijuana users were Ontario experience 1 1 1
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identified and were matched to 7674 controls who reported not using 1 Ahmed Kotb , Walid Shahrour , Owen Prowse , Hazem Elmansy
marijuana. Mean age of marijuana users was 34.3 years (±3.2) and of Urology, Northern Ontario School of Medicine, Thunder Bay, ON,
controls was 36.7 years (±2.8). The mean frequency of sexual activity Canada
was higher in marijuana users at 8.8 times/month (±5.1) compared with Introduction: Top–down holmium laser enucleation of the prostate
non–users at 7.8 times/month (±4.9) (p<0.001). The mean serum testoster- (HoLEP) has emerged as a novel modification for the original HoLEP,
one concentration was significantly higher among marijuana users 14.27 aiming for better visualization of the apical urethral mucosa and higher
nmol/L (±6.1), compared to non–users 12.96 nmol/L (±5.9) (p<0.001). continence rate. The aim of our study was to present our first Ontario
Similarly, marijuana users reported higher SHIM scores (21.9±4.4 vs. experience in applying HoLEP modification in a group of patients with
21.3±4.7) (p<0.001). Marijuana users were more likely to report posi- benign prostatic hyperplasis (BPH).
tive ADAM scores (33.9% vs. 29.5% in non–users) (p<0.001). Finally, Methods: Our study included 20 consecutive patients managed by a
marijuana users were less likely to report a SHIM score ≤21 (29% vs. single urologist (HE). Top–down HoLEP was performed. Holmium laser
34%)(p<0.001). (100 Watt), a continuous flow (28 Fr) resectoscope, and a tissue morcel-
S82 CUAJ • June 2018 • Volume 12(6Suppl2)