MP71-02 ASSESSING THE IMPACT OF HYPOGONADISM ON SURGICAL OUTCOMES FOLLOWING ARTIFICIAL URINARY SPHINCTER PLACEMENT

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP71-02 ASSESSING THE IMPACT OF HYPOGONADISM ON SURGICAL OUTCOMES FOLLOWING ARTIFICIAL URINARY SPHINCTER PLACEMENT Andrew Gabrielson, Logan Galansky, Una Choi, and Andrew Cohen Andrew GabrielsonAndrew Gabrielson More articles by this author , Logan GalanskyLogan Galansky More articles by this author , Una ChoiUna Choi More articles by this author , and Andrew CohenAndrew Cohen More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003339.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Retrospective series suggest a link between hypogonadism and complications following artificial urinary sphincter (AUS) placement. We sought to confirm this finding and evaluate whether testosterone replacement therapy (TRT) in hypogonadal patients prior to AUS placement mitigates this risk. METHODS: A retrospective cohort study was conducted using the TriNetX research network between 2006-2022. We defined 4 groups: 1) Eugonadal patients undergoing AUS, 2) Hypogonadal patients (>1 confirmatory T level <300 ng/dL) with and without TRT, 3) Hypogonadal patients who received TRT prior to AUS, 4) Hypogonadal patients who did not receive TRT prior to AUS. Propensity-score matching was used in comparing baseline differences in comorbidities of the eugonadal and hypogonadal arms. Outcomes included 5-year all-cause revision (cuff erosion, mechanical, infectious), 5-year device complication (mechanical, infectious only), and 90-day surgical site infection (SSI) rate. RESULTS: We included 4,520 eugonadal and 514 hypogonadal patients (19% with TRT, 81% without TRT) undergoing AUS (Table 1). Compared to eugonadal patients, the hypogonadal cohort had a significantly higher 5-year device complication (17% vs 13%, p=0.03) and 90-day SSI rate (2% vs 0.8%, p<0.01), but no difference in 5-year revision rate (26% vs 24%, p=0.21). When comparing hypogonadal patients who received TRT prior to AUS versus hypogonadal patients who did not receive TRT, we found no difference in 5-year revision (32% vs 26%, p=0.19), 5-year device complication (23% vs. 16%, p=0.10), or 90-day SSI (1.1% vs. 1.9%, p=0.48) rates. Hypogonadal patients receiving TRT before AUS were more likely to have pre-existing erectile dysfunction and penile implant surgery, but had similar rates of radical prostatectomy. Post-AUS, only 22 (5.3%) patients in the non-TRT arm received new TRT, suggesting minimal crossover. There was no difference in 5-year revision between eugonadal and hypogonadal patients not receiving TRT. CONCLUSIONS: Pre-existing hypogonadism may impact early SSI rates and long-term mechanical or infectious complications but was not associated with higher rates of all-cause revision likely due to similar rates of cuff erosion. TRT does not appear to impact surgical outcomes among hypogonadal patients undergoing AUS placement. Source of Funding: NA © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1013 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrew Gabrielson More articles by this author Logan Galansky More articles by this author Una Choi More articles by this author Andrew Cohen More articles by this author Expand All Advertisement PDF downloadLoading ...