MP88-14 ARTIFICIAL URINARY SPHINCTER OUTCOMES IN OCTOGENARIANS

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Male Incontinence: Therapy1 Apr 2015MP88-14 ARTIFICIAL URINARY SPHINCTER OUTCOMES IN OCTOGENARIANS Matthew J. Ziegelmann, Brian J. Linder, Joshua Piotrowski, Boyd R. Viers, David Barrett, and Daniel S. Elliott Matthew J. ZiegelmannMatthew J. Ziegelmann More articles by this author , Brian J. LinderBrian J. Linder More articles by this author , Joshua PiotrowskiJoshua Piotrowski More articles by this author , Boyd R. ViersBoyd R. Viers More articles by this author , David BarrettDavid Barrett More articles by this author , and Daniel S. ElliottDaniel S. Elliott More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1847AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Stress urinary incontinence (SUI) has a significant impact on a patient's quality of life. As the average male life expectancy continues to increase, it is likely that we will see an increasing number of older patients seeking treatment for SUI. To date, few studies have evaluated artificial urinary sphincter (AUS) placement in older men, and little data exists with which to counsel this specific group of patients preoperatively. Thus, we sought to assess the outcomes in octogenarians undergoing AUS placement. METHODS From 1983-2012, 2005 AUS surgeries were performed at our institution. Of these 2005, 1157 (58%) were primary AUS placement. 101 (8.7%) men were >/= 80 years old at the time of their primary implant surgery. Outcomes evaluated included AUS revisions and explantations, and these were compared between men < 80 years old and those >/= 80 years. A multivariate Cox proportional logistic regression model with competing risk analysis was utilized to identify covariates independently associated with AUS device outcomes (removal or revision). Specific variables included age (< 80 years, and >/= 80 years), tobacco use, coronary artery disease (CAD), hypertension, diabetes mellitus, history of prostate radiation, current or prior androgen deprivation therapy, and history of bladder neck contracture. RESULTS In total, 101 men undergoing primary AUS placement were 80 years or older, with a median age of 82.5, compared with a median age of 69.8 in those patients less than 80 years old. When stratified by age, octogenarians were more likely to have a history of coronary artery disease (25% vs 14%, respectively; p=0.003). On univariate analysis, there was no significant difference in overall AUS revision events between octogenarians and those patients less than 80 years old (HR 0.86, p=0.5). However, octogenarians were significantly more likely to experience device erosion/infection (HR 2.31, p=0.008). On multivariable analysis, advanced age (>/= 80) was independently associated with a significantly increased risk of device erosion/infection (HR 2.055, p=0.03). CONCLUSIONS While the overall rate of AUS revisions is similar for younger and older patients, octogenarians are twice as likely to experience device erosion or infection. Recognizing this increased risk is important to consider when counseling patients preoperatively. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1097 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matthew J. Ziegelmann More articles by this author Brian J. Linder More articles by this author Joshua Piotrowski More articles by this author Boyd R. Viers More articles by this author David Barrett More articles by this author Daniel S. Elliott More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...