MP52-18 CHRONIC SUPRAPUBIC TUBE URINARY DIVERSION AS A MINIMALLY INVASIVE STRATEGY FOR RESOLUTION OF INCONTINENCE FOR COMPLEX RADIATION-INDUCED STRICTURES

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) II1 Apr 2016MP52-18 CHRONIC SUPRAPUBIC TUBE URINARY DIVERSION AS A MINIMALLY INVASIVE STRATEGY FOR RESOLUTION OF INCONTINENCE FOR COMPLEX RADIATION-INDUCED STRICTURES Kunj R. Sheth, Matthias D. Hofer, Nicholas L. Kavoussi, Billy H. Cordon, Jeremy M. Scott, and Allen F. Morey Kunj R. ShethKunj R. Sheth More articles by this author , Matthias D. HoferMatthias D. Hofer More articles by this author , Nicholas L. KavoussiNicholas L. Kavoussi More articles by this author , Billy H. CordonBilly H. Cordon More articles by this author , Jeremy M. ScottJeremy M. Scott More articles by this author , and Allen F. MoreyAllen F. Morey More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.494AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Radiation-induced urethral strictures can be complex and reconstruction challenging with the potential to become subsequently incontinent. We report on our experience treating patients with chronic suprapubic tubes (SPT) as an alternative to urethral reconstruction for men with radiation-induced urethral strictures. METHODS We retrospectively reviewed all patients that underwent SPT placement at our institution from 2008-2015. We identified 68 patients that received SPTs for radiation-induced urethral strictures and had a minimum of 6 months follow-up. Patient and stricture characteristics were recorded. RESULTS Among 68 patients with radiation-induced urethral strictures who underwent SPT placement at our institution, 31/68 (46%) chose to continue with a chronic SPT whereas 37/68 (54%) elected to subsequently undergo urethral reconstruction. Patients electing a chronic SPT were slightly older than those undergoing reconstruction (72.9 years versus 70.1 years, p = 0.16), but otherwise shared similar characteristics. Stress urinary incontinence (SUI) at time of initial presentation was reported by 22/31 (71%) patients and resolved after SPT placement in 9/22 (41%) patients. The majority of patients (16/31 (51.2%)) managed with a chronic SPT reported no side effects. Development of bladder stones occurred in 7/31 (22.6%) patients and 12/31 (38.7%) patients reported irritative bladder symptoms, the majority of whom (7/12 (58.3%)) had radiation-induced cystitis. Five patients with refractory radiation cystitis ultimately underwent ileal conduit urinary diversion for their symptoms. CONCLUSIONS Chronic SPT can be a successful initial management strategy for refractory radiation-induced urethral strictures in patients unwilling to undergo open urethral reconstruction. SPT is overall well tolerated and can resolve incontinence in nearly half of patients. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e695-e696 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Kunj R. Sheth More articles by this author Matthias D. Hofer More articles by this author Nicholas L. Kavoussi More articles by this author Billy H. Cordon More articles by this author Jeremy M. Scott More articles by this author Allen F. Morey More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...