LBA01-05: Associations Between Race and Erectile Dysfunction Treatment Patterns

Sunday, September 12, 2021 8:00 PM to 8:50 PM


Authors: Tony Chen, Shufeng Li, Michael Eisenberg

Introduction: Erectile dysfunction (ED) treatments are effective and widely available. While it has been previously demonstrated that different races in the United States display varied prevalence of ED it remains uncertain whether treatment-seeking patterns differ by race/ethnicity. In this present study, we examine the relationship between race and erectile dysfunction treatment.

Methods: We performed a retrospective review using Optum’s De-identified Clinformatics® Data Mart database. Administrative diagnosis, procedural, and pharmacy codes were used to identify male subjects 18 years and older with a diagnosis of ED between 2003 and 2018. Demographic variables (i.e. race, education level, and income level) and clinical factors were identified. Men with less than a year of enrollment before or after ED diagnosis were excluded. Men with a history of prostate cancer were excluded. Types and patterns of ED treatment (oral agents, intraurethral agents, intracavernosal injection, vacuum erection device, and surgery) were analyzed after adjusting for age, income, education, frequency of urologist visits, smoking status, and metabolic syndrome (MetS) comorbidity diagnoses. All analyses were performed in SAS software version 9.4 (SAS Institute Inc., Cary, NC).

Results: During the observation period, 810,916 men were identified who met the inclusion criteria with a median follow-up time of 3.8 years. 74.9% of the patients were Caucasian, 10.5% were African American (AA), 11.5% were Hispanic, and 3.1% were Asian. Caucasian and Asian men reported higher educational attainment and annual income. 34.6% of Caucasians, 36.4% of AAs, 29.% of Hispanics, and 30.8% of Asians underwent any ED treatment. 0.27% of Caucasians, 0.44% of AA, 0.21% of Asians, and 0.40% of Hispanic men underwent surgery for ED. After matching for demographic and clinical factors, differences in ED treatment persisted. Compared to Caucasians, Asian and Hispanic men had significantly lower odds of undergoing any ED treatment (OR 0.81 and 0.85 respectively), while AAs had higher odds of ED treatment (OR 1.13). Of men who underwent ED treatment, AA and Hispanic men were more likely to undergo surgery than Caucasian men (OR 1.19 and 1.37 respectively).

Conclusions: Differences in ED treatment patterns exist across racial groups even after accounting for socioeconomic variables, and Asian and Hispanic men are less likely to receive ED treatment. Whether this finding is due to patient preference, physician or health system biases, or a combination of factors, an opportunity exists to further investigate potential barriers to men receiving care for sexual dysfunction.

Source of Funding: National Institutes of Health National Center for Advancing Translational Science Clinical and Translational Science Award (UL1 TR001085)