MP40-14 THE IMPACT OF PRIOR EXTERNAL BEAM RADIATION THERAPY ON DEVICE OUTCOMES FOLLOWING ARTIFICIAL URINARY SPHINCTER REVISION SURGERY

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence: Therapy I (MP40)1 Apr 2020MP40-14 THE IMPACT OF PRIOR EXTERNAL BEAM RADIATION THERAPY ON DEVICE OUTCOMES FOLLOWING ARTIFICIAL URINARY SPHINCTER REVISION SURGERY Madeleine G. Manka*, Brian J. Linder, Laureano J. Rangel, and Daniel S. Elliott Madeleine G. Manka*Madeleine G. Manka* More articles by this author , Brian J. LinderBrian J. Linder More articles by this author , Laureano J. RangelLaureano J. Rangel More articles by this author , and Daniel S. ElliottDaniel S. Elliott More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000889.014AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Previous reports on the effect of radiation therapy on primary artificial urinary sphincter (AUS) device survival have met with conflicting results, and data evaluating this after revision surgery is sparse. Thus, we evaluated artificial urinary sphincter device outcomes after revision surgery, and compared them among individuals who did versus did not undergo prior radiation therapy. METHODS: A database of patients who underwent AUS revision surgery at our institution was used to perform a retrospective review. Device survival endpoints, including overall survival, infection/erosion, urethral atrophy, and device malfunction were evaluated. Overall device survival (i.e. any repeat surgery) was compared between groups, stratified by external beam radiation status, via Kaplan-Meier method. Proportional hazard regression and competing risk analysis were used to evaluate association between prior radiation therapy and device outcomes. RESULTS: From 1983 to 2016, a total of 527 patients underwent AUS revision surgery. Of these, 173 (33%) patients had undergone prior radiation therapy. Patients with prior radiation therapy were more likely to have diabetes mellitus (22% vs 14%; p = 0.05), hypertension (70% vs 56%; p < 0.01), previous vesicourethral anastomotic stenosis (41% vs 19%; p < 0.0001), as well as prior androgen deprivation therapy (26% vs 6%; p < 0.0001). Overall, there was not enough evidence to support the existence of a significant difference in device survival among patients with or without a history of radiotherapy, with 1 and 5 year-overall survival of 84% vs 85% and 50% vs 64%, respectively (p = 0.08). On competing risk analysis, a history of pelvic radiation therapy was not enough evidence to support a significant association with the risk of device infection/erosion, mechanical failure, or urethral atrophy. CONCLUSIONS: There was not enough evidence of a difference in the rate of device erosion or infection, cuff atrophy, malfunction, or overall device survival following AUS revision surgery between patients with and without a history of pelvic radiation. These findings may be helpful when counseling patients regarding outcomes after AUS revision. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e591-e591 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Madeleine G. Manka* More articles by this author Brian J. Linder More articles by this author Laureano J. Rangel More articles by this author Daniel S. Elliott More articles by this author Expand All Advertisement PDF downloadLoading ...