Prevalence and Predictors of Ejaculatory Dysfunction in Men Presenting For Andrological Evaluation http://www.aua2015.org/abstracts/abstractprint.cfm?id=MP43-16 Authors: Matthew Pagano, Alison Levy, Adam De Fazio, Peter Stahl, New York, NY Introduction and Objectives - Ejaculatory dysfunction can frequently coexist with other urologic problems and may be underdiagnosed. We sought to describe predictors of ejaculatory dysfunction in men presenting for andrological evaluation in order to identify factors that could be used to trigger screening in at risk men. Methods - This was a retrospective study of 678 men presenting to an andrologist for initial consultation from 1/2013 to 7/2014. Patients with a history of treated prostate cancer were excluded. Presenting complaint(s), demographic data, comorbidities, endocrine studies, and responses to the validated 25-question Male Sexual Health Questionnaire (MSHQ) were reviewed. Ejaculatory domain score (EjD) and ejaculation bother scores for each presenting complaint were compared by Mann-Whitney U test to a control group of men with normal sexual function who presented for vasectomy. Univariate linear regression modeling was conducted to identify clinical factors predictive of overall EjD score, and significant factors were studied in a multivariable model. Results - Characteristics of the patient cohort were as follows: mean age 46.6, rate of diabetes (DM) 12.1%, hypertension (HTN) 23.2%, depression 18.3%, benign prostatic hyperplasia (BPH) 11.2%. Mean erection domain (ED) and EjD scores were 8.9 (scale 0-15) and 25.7 (scale 1-35), respectively. Men who presented with infertility, scrotal pain, Peyronie’s disease (PD), penile pain, scrotal swelling, hypogonadism, and erectile dysfunction (ED) reported significantly lower EjD scores than controls, and most groups reported more bother related to ejaculation (Figure). Clinical factors associated with lower EjD score on univariate analysis included age, total testosterone, body mass index, coronary artery disease, HTN, hyperlipidemia, DM, chronic kidney disease, neurologic disease (ND), depression, BPH, tobacco use, and MSHQ ED score. On multivariable analysis ED score (p<0.0005), DM (p=0.025), and ND (p=0.006) were predictive of lower EjD score. Conclusions - Impaired ejaculatory function is highly prevalent in men seeking andrological evaluation and causes patient bother. Focused history taking or use of a validated instrument will identify men who may benefit from treatment. Patients with ED, DM, and neurologic disease are at high risk and should be screened.