MP71-07 THE RISK OF COMPLICATIONS, INFECTIONS, AND RE-INTERVENTIONS IN MEN RECEIVING ARTIFICIAL URINARY SPHINCTERS, A GLOBAL, PROPENSITY SCORE MATCHED ANALYSIS

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP71-07 THE RISK OF COMPLICATIONS, INFECTIONS, AND RE-INTERVENTIONS IN MEN RECEIVING ARTIFICIAL URINARY SPHINCTERS, A GLOBAL, PROPENSITY SCORE MATCHED ANALYSIS Zachary Prebay, Halle Foss, David Ebbott, Michael Li, and Paul Chung Zachary PrebayZachary Prebay More articles by this author , Halle FossHalle Foss More articles by this author , David EbbottDavid Ebbott More articles by this author , Michael LiMichael Li More articles by this author , and Paul ChungPaul Chung More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003339.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Artificial urinary sphincters (AUS) are treatments for patients with stress urinary incontinence. However, risk factors for implant infection, complication, or re-intervention (removal, repair, replacement) are incompletely understood. METHODS: We queried the TriNetX database for all adult male patients undergoing AUS utilizing CPT codes. We evaluated the impact of age, body mass index, race, ethnicity, diabetes (DM), smoking history, history of radiation therapy (RT), history of radical prostatectomy (RP) and history of urethroplasty on select clinical outcomes utilizing ICD-10 codes. Our primary outcome was the need for re-intervention defined by CPT codes. Secondary outcomes included overall device complication rate and infection rate defined by ICD codes. Analytics were performed on TriNetX which calculated risk ratios (RR). We evaluated our outcomes first on the entire population and then repeated analyses for each individual comparison cohort using the remaining demographic variables to perform propensity score matching (PSM). RESULTS: Analyses were run on September 22nd, 2022. The overall rates of AUS re-intervention, complication and infection were 23.4%, 24.1% and 6.4%, respectively (Table 1). Kaplan Meier analysis showed median AUS survival (no need for re-intervention) at 10.6 years and projected 20-year survival probability at 31.3%. Patients with a history of smoking or urethroplasty were at higher risk of AUS complication (31.0% vs 25.6%, RR 1.21, p<0.01; 37.6% vs 23.3%, RR 1.62, p<0.01) and re-intervention (27.6% vs 22.1%, RR 1.25, p<0.01; 35.1% vs 24.2%, RR 1.45, p=0.03). Patients with DM (8.5% vs 5.7%, RR 1.48, p=0.02) or a history of RT (8.3% vs 4.3%, RR 1.92, p<0.01) were at higher risk of AUS infection. Patients with a history of RP were at a lower risk of AUS infection (4.4% vs 7.8%, RR 0.56, p<0.01). Patients with a history of RT were at higher risk of AUS complication (26.6% vs 21.2%, RR 1.25, p=0.02). All risk factors besides race showed a difference in device removal itself (p<0.05). CONCLUSIONS: Multiple characteristics are associated with risk of re-intervention, infection, or complication. These results can help guide patient selection and counseling with the goal of reducing complications. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1016 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Zachary Prebay More articles by this author Halle Foss More articles by this author David Ebbott More articles by this author Michael Li More articles by this author Paul Chung More articles by this author Expand All Advertisement PDF downloadLoading ...