DELAY IN PENILE PROSTHESIS AND ARTIFICIAL URINARY SPHINCTER SURGERY FOLLOWING RADICAL PROSTATECTOMY: LESSONS FROM A STATEWIDE DATABASE

You have accessJournal of UrologySexual Function/Dysfunction: Surgical Therapy II1 Apr 2018MP32-06 DELAY IN PENILE PROSTHESIS AND ARTIFICIAL URINARY SPHINCTER SURGERY FOLLOWING RADICAL PROSTATECTOMY: LESSONS FROM A STATEWIDE DATABASE Denise Asafu-Adjei, Cooper Benson, Stephanie Thompson, Doreen E. Chung, Gen Li, Matthew Rutman, James Kashanian, Doron Stember, and Peter J. Stahl Denise Asafu-AdjeiDenise Asafu-Adjei More articles by this author , Cooper BensonCooper Benson More articles by this author , Stephanie ThompsonStephanie Thompson More articles by this author , Doreen E. ChungDoreen E. Chung More articles by this author , Gen LiGen Li More articles by this author , Matthew RutmanMatthew Rutman More articles by this author , James KashanianJames Kashanian More articles by this author , Doron StemberDoron Stember More articles by this author , and Peter J. StahlPeter J. Stahl More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1056AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES This is the first population based report of the timing and utilization of prosthetic surgery following radical prostatectomy (RP). While spontaneous resolution of erectile dysfunction (ED) and stress urinary incontinence (SUI) can occur within 24-36 and 6-24 months, respectively, many patients develop permanent ED and/or SUI. Our objective was to evaluate patterns of utilization for definitive treatment of ED and SUI with penile prosthesis (PP) and artificial urinary sphincter (AUS) surgery after RP. METHODS The New York Statewide Planning and Research Cooperative System (SPARCS) database was queried for ICD9 and CPT codes to identify patients who underwent RP from 1995-2014. The RP cohort was then queried for ICD9 and CPT codes indicating insertion, removal, repair, and replacement of PP and/or AUS. We analyzed the proportions of RP patients that underwent urologic prosthetic surgery, and the time lapses from RP to prosthetic insertion. RESULTS We identified 97,095 patients who underwent RP from 1995-2014. Patterns of urologic prosthetic placement are listed in Table 1. Overall, AUS surgery was performed in 0.26% (255/97,095) of the RP cohort. The mean time from RP to initial insertion of AUS was 45.6± 31.2 months. PP surgery was performed in 2.10% of the RP cohort. The mean time from RP to PP was 73.4±61.4 months. CONCLUSIONS Our analysis of this population based dataset revealed significant delays and potential underutilization of AUS and PP surgery for men who underwent RP. AUS placement occurred on average almost two years after the time at which further recovery of continence is unlikely. PP prosthesis surgery similarly occurred on average more than three years after the time at which further cavernous nerve recovery is unlikely. Further investigation is necessary to determine if the observed delays in definitive surgical care represent prolonged use of conservative treatments or periods of non-treatment that could be driven by lack of access to prosthetic urologists or other factors. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e421-e422 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Denise Asafu-Adjei More articles by this author Cooper Benson More articles by this author Stephanie Thompson More articles by this author Doreen E. Chung More articles by this author Gen Li More articles by this author Matthew Rutman More articles by this author James Kashanian More articles by this author Doron Stember More articles by this author Peter J. Stahl More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...