MP46-06 COMPARISON OF ADJUVANT RADIATION THERAPY BEFORE OR AFTER ARTIFICIAL URINARY SPHINCTER PLACEMENT: A MULTI-INSTITUTIONAL ANALYSIS

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence: Therapy1 Apr 2017MP46-06 COMPARISON OF ADJUVANT RADIATION THERAPY BEFORE OR AFTER ARTIFICIAL URINARY SPHINCTER PLACEMENT: A MULTI-INSTITUTIONAL ANALYSIS Kenneth DeLay, Nora Haney, Andrew Gabrielson, Jason Chiang, Carrie Stewart, Faysal Yafi, Kenneth Angermeier, John Lacy, Hadley Wood, Timothy Boone, Alex Kavanagh, Matthew Gretzer, Stuart Boyd, Jeff Loh-Doyle, and Wayne Hellstrom Kenneth DeLayKenneth DeLay More articles by this author , Nora HaneyNora Haney More articles by this author , Andrew GabrielsonAndrew Gabrielson More articles by this author , Jason ChiangJason Chiang More articles by this author , Carrie StewartCarrie Stewart More articles by this author , Faysal YafiFaysal Yafi More articles by this author , Kenneth AngermeierKenneth Angermeier More articles by this author , John LacyJohn Lacy More articles by this author , Hadley WoodHadley Wood More articles by this author , Timothy BooneTimothy Boone More articles by this author , Alex KavanaghAlex Kavanagh More articles by this author , Matthew GretzerMatthew Gretzer More articles by this author , Stuart BoydStuart Boyd More articles by this author , Jeff Loh-DoyleJeff Loh-Doyle More articles by this author , and Wayne HellstromWayne Hellstrom More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1445AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Artificial Urinary Sphincter (AUS) remains the gold standard in the management of male stress urinary incontinence following radical prostatectomy. However, the impact of AUS placement before or after adjuvant radiation therapy has limited coverage in the literature. The objective of this study was to determine if the timing of radiation therapy has an impact on AUS outcomes, as well as identify predictors of AUS-related complications. METHODS A retrospective review was conducted across five academic institutions of men who received AUS placement and adjuvant radiation therapy between 1993 and 2016. A total of 306 men were included in the study. Out of the 306 men, 292 (95.4%) received radiation before AUS placement (Group 1) and 14 (4.6%) men received radiation after AUS placement (Group 2). Collected variables included demographics, type of prostate cancer therapy, and AUS device specifications. Primary endpoints included complication rates, revision rates, and number of pads per day before and after AUS treatment. Bivariate analysis was used to examine the association between pretreatment comorbidities and the incidence of AUS-related complications postoperatively. RESULTS Median duration of follow-up for the entire cohort was 30 months (range 4-148 months). Group 1 was followed for a median of 29 months (range 4-148 months), while Group 2 was followed for a median of 49 months (range 12-141 months). There was no difference between groups in the percentage of men who experienced postoperative complications (P = 0.832). In Group 1, 26.0% of patients experienced postoperative complications while 28.6% of patients in Group 2 experienced postoperative complications. While the number of pads per day decreased significantly from before AUS placement to after AUS placement, there was no significant difference in the average number of pads used per day between Group 1 and Group 2 (P = 0.907). The number of pads used per day in Group 1 before AUS placement was 5.24 ± 3.12 which decreased to 1.13 ± 1.31 (P < 0.001). In Group 2, the number of pads used per day before surgery was 6.09 ± 1.97 which decreased to 1.53±0.99 pads per day after AUS placement (P < 0.001). The percentage of men requiring revision in Group 1 was 31.2%, while the percentage of revisions in Group 2 was 14.3%(P = 0.028). The median time to revision was 14 months and 18.5 months for Group 1 and Group 2, respectively. The presence of peripheral vascular disease (PVD) and coronary artery disease (CAD) was associated with increased incidence of AUS-related complications (primarily refractory incontinence and cuff erosion) in both Groups (P = 0.032). The following factors were not significant: age, race, smoking, hypertension, diabetes mellitus, dyslipidemia, BMI, AUS device specifications, type of radiation therapy. CONCLUSIONS The timing of radiation therapy does not have a significant impact on complication rates or urinary continence as represented by number of pads used post-AUS placement. There is a non-statistical association between lower revision rates in patients who underwent radiation after AUS placement, as compared to before AUS placement. Patients with pre-existing PVD or CAD may experience more frequent postoperative complications, but this study is underpowered. Further research is needed to confirm these findings. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e621 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Kenneth DeLay More articles by this author Nora Haney More articles by this author Andrew Gabrielson More articles by this author Jason Chiang More articles by this author Carrie Stewart More articles by this author Faysal Yafi More articles by this author Kenneth Angermeier More articles by this author John Lacy More articles by this author Hadley Wood More articles by this author Timothy Boone More articles by this author Alex Kavanagh More articles by this author Matthew Gretzer More articles by this author Stuart Boyd More articles by this author Jeff Loh-Doyle More articles by this author Wayne Hellstrom More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...