PD04-05 SURVIVAL OF ARTIFICIAL URINARY SPHINCTER IN SIMULTANEOUS VS STAGED ARTIFICIAL URINARY SPHINCTER AND PENILE PROSTHESIS IMPLANTATION

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence: Therapy I (PD04)1 Sep 2021PD04-05 SURVIVAL OF ARTIFICIAL URINARY SPHINCTER IN SIMULTANEOUS VS STAGED ARTIFICIAL URINARY SPHINCTER AND PENILE PROSTHESIS IMPLANTATION Nathan Cheng, Nickolas Dalbec, Dongfeng Qi, Guanghui Liu, and David Shin Nathan ChengNathan Cheng More articles by this author , Nickolas DalbecNickolas Dalbec More articles by this author , Dongfeng QiDongfeng Qi More articles by this author , Guanghui LiuGuanghui Liu More articles by this author , and David ShinDavid Shin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001968.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urinary incontinence (UI) and erectile dysfunction (ED) are important quality-of-life measures especially after prostate cancer treatment. When both conditions are present, simultaneous artificial urinary sphincter (AUS) and penile prosthesis (PP) implantation can be performed to treat UI and ED, respectively. We sought to evaluate device survival outcomes in men who underwent simultaneous vs. staged AUS and PP implantation for UI and ED. METHODS: Analysis of 21 years of a national prospectively maintained Boston Scientific database was performed (1995-2016). Patients were placed into three subgroups based on timeline of implantation: AUS first then PP (AUS1), PP first then AUS (AUS2), and simultaneous AUS and PP (SIMAUS). Patients were stratified by surgical approaches for AUS and PP implantation. Implant survival (time to revision or explantation) analysis was performed using log-rank test. RESULTS: 6770 patients were included in the study. AUS survival from revision showed AUS1>SIMAUS>AUS2 at 5-years (89.1% vs 84.3% vs 79.5%), 10-years (84.3% vs 80.1% vs 75.2%), 15-years (82.2% vs 78.5% vs 74.0%), and 20-years (81.3% vs 77.8% vs 74.0%) after initial device implantation, all p<0.001. AUS survival from explantation showed AUS1>SIMAUS>AUS2 at 5-years (90.8% vs 85.6% vs 82.0%) and 10-years (77.7% vs 75.0% vs 72.0%), but SIMAUS>AUS1 or AUS2 at 15-years (70.4% vs 66.3% vs 65.0%) and 20-years (69.7% vs 58.2% vs 65.0%), all p≤0.003. In a subgroup of 1119 men undergoing perineal AUS and penoscrotal IPP approach, AUS revision survival showed AUS1>SIMAUS>AUS2 at 5-years (93.1% vs 83.9% vs 79.7%, p<0.001) and 10-years (92.4% vs 80.7% vs 79.7%, p<0.001). AUS explantation survival also showed AUS1>SIMAUS>AUS2 at 5-years (93.5% vs 86.6% vs 79.8%, p<0.001) and 10-years (72.6% vs 68.7% vs 65.4%, p=0.002). CONCLUSIONS: For dual UI and ED diagnosis, AUS survival from revision up to 20 years or explantation up to 10 years is best seen in patients who undergo staged placement of AUS first followed by PP, as highlighted by perineal AUS and penoscrotal PP surgical approach. However, simultaneous AUS and PP implantation offers better long term (>10 years) AUS survival from explantation. Source of Funding: Boston Scientific © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e51-e51 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nathan Cheng More articles by this author Nickolas Dalbec More articles by this author Dongfeng Qi More articles by this author Guanghui Liu More articles by this author David Shin More articles by this author Expand All Advertisement Loading ...