MP88-11 EXTERNAL BEAM RADIATION THERAPY AFTER MALE TRANSOBTURATOR SLING PLACEMENT INCREASES FAILURE RATES

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Male Incontinence: Therapy1 Apr 2015MP88-11 EXTERNAL BEAM RADIATION THERAPY AFTER MALE TRANSOBTURATOR SLING PLACEMENT INCREASES FAILURE RATES Divya Ajay, John Selph, Michael Belsante, Ngoc-Bich Le, Aaron Lentz, George Webster, and Andrew Peterson Divya AjayDivya Ajay More articles by this author , John SelphJohn Selph More articles by this author , Michael BelsanteMichael Belsante More articles by this author , Ngoc-Bich LeNgoc-Bich Le More articles by this author , Aaron LentzAaron Lentz More articles by this author , George WebsterGeorge Webster More articles by this author , and Andrew PetersonAndrew Peterson More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1844AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Post-prostatectomy stress urinary incontinence (PPSUI) is a well−recognized side effect of treatment for prostate cancer that negatively impacts quality of life. There is ample evidence to suggest that patients who undergo external beam radiation therapy (EBRT) prior to transobturator sling (TOS) placement have high rates of TOS failure. However, whether EBRT delivered for biochemical recurrence after TOS placement affects continence outcomes is not known. Our objective was to evaluate TOS outcomes in patients with post-sling EBRT. METHODS We conducted an IRB approved review of all patients undergoing a male TOS placement from 2006 to 2012 at our institution. Patients who underwent placement of TOS were identified using our patient data portal (DEDUCE). Demographic and follow-up data were extracted by chart review. Success was defined post-operatively by the use of 0 or 1 security pad, a negative stress test on exam, or pad weight of less than 8 g per 24 hours. Student's T-test was performed. RESULTS During this time period 290 TOS were performed. Of these, we identified 11 patients who received EBRT after TOS placement. All of these underwent a radical prostatectomy for prostate cancer and presented with PPSUI. Average age at TOS surgery was 66.3 years (± 7.4). They underwent EBRT at a median of 18 months (IQR 11-38) from TOS placement. 8/11 (73%) were dry prior to EBRT. Of the patients who were dry, 87.5% (7/8) reported TOS failure after EBRT treatment at a median of 0 months (IQR 0-11) from the end of radiation therapy. This is in comparison to a 42.6% overall failure rate in the entire cohort (p<0.01). CONCLUSIONS EBRT delivered after male TOS placement may cause TOS failure. This information will be helpful in clinical decision making for PPSUI patients with advanced stage prostate cancer or with positive surgical margins at radical prostatectomy who may need adjuvant EBRT. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1096 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Divya Ajay More articles by this author John Selph More articles by this author Michael Belsante More articles by this author Ngoc-Bich Le More articles by this author Aaron Lentz More articles by this author George Webster More articles by this author Andrew Peterson More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...