ARTIFICIAL URINARY SPHINCTER AND URETHRAL SLING IS UNDERUTILIZED FOLLOWING RADICAL PROSTATECTOMY: RESULTS FROM A STATEWIDE CLAIMS DATABASE

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence: Therapy II (PD37)1 Apr 2019PD37-06 ARTIFICIAL URINARY SPHINCTER AND URETHRAL SLING IS UNDERUTILIZED FOLLOWING RADICAL PROSTATECTOMY: RESULTS FROM A STATEWIDE CLAIMS DATABASE Marc Nelson*, Ryan Dornbier, Eric Kirshenbaum, Emanuel Eguia, Patrick Sweigert, Marshall Baker, Joe Mahon, Ahmer Farooq, Kevin McVary, Gopal Gupta, and Larissa Bresler Marc Nelson*Marc Nelson* More articles by this author , Ryan DornbierRyan Dornbier More articles by this author , Eric KirshenbaumEric Kirshenbaum More articles by this author , Emanuel EguiaEmanuel Eguia More articles by this author , Patrick SweigertPatrick Sweigert More articles by this author , Marshall BakerMarshall Baker More articles by this author , Joe MahonJoe Mahon More articles by this author , Ahmer FarooqAhmer Farooq More articles by this author , Kevin McVaryKevin McVary More articles by this author , Gopal GuptaGopal Gupta More articles by this author , and Larissa BreslerLarissa Bresler More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556362.84856.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Stress urinary incontinence (SUI) following radical prostatectomy is a common and potentially debilitating complication, affecting up to one third of patients. For men who fail conservative measures to treat SUI, surgical therapy with either a urethral sling or artificial urinary sphincter (AUS) is an effective, durable option. Little is known about the contemporary utilization of surgical therapy for SUI following radical prostatectomy. METHODS: The Healthcare Cost and Utilization Project State Inpatient Database (SID) and State Ambulatory Surgery Database (SASD) for Florida from 2009-2015 was utilized. ICD-9 procedure codes were used to identify men who underwent radical prostatectomy between 2009 and 2013. Patients were tracked longitudinally for ambulatory or inpatient urethral sling or artificial urinary sphincter placement. Patient and clinical data were extracted and analyzed with descriptive statistics. A multivariable logistic regression model was utilized to determine risk-adjusted predictors of penile prosthesis placement. RESULTS: 20,520 males underwent radical prostatectomy during the study period. 2.9% of these men had subsequent incontinence surgery, at an average of 729 days following prostatectomy. Of those who underwent SUI surgery, 52.3% had initial urethral sling placement and 44.5% had initial AUS placement. On univariate analysis, men who underwent incontinence surgery were older (63.3 vs 61.8 years, p<0.005). (Table 1) On multivariate analysis, Medicare (OR 1.51, p<0.005) or Medicaid (OR 1.87, p=0.002) insurance and a diagnosis of diabetes (OR 1.41, p=0.006) all were associated with increased odds of SUI surgery. (Graph 2) CONCLUSIONS: The known rate of post-prostatectomy SUI far exceeds the utilization of AUS and urethral sling. Further investigation is warranted to determine barriers to adoption. Source of Funding: none Chicago, IL; Maywood, IL© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e663-e664 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marc Nelson* More articles by this author Ryan Dornbier More articles by this author Eric Kirshenbaum More articles by this author Emanuel Eguia More articles by this author Patrick Sweigert More articles by this author Marshall Baker More articles by this author Joe Mahon More articles by this author Ahmer Farooq More articles by this author Kevin McVary More articles by this author Gopal Gupta More articles by this author Larissa Bresler More articles by this author Expand All Advertisement PDF downloadLoading ...