PD16-09 HYPOGONADISM IS A RISK FACTOR FOR ARTIFICIAL URINARY SPHINCTER CUFF EROSION

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) I1 Apr 2016PD16-09 HYPOGONADISM IS A RISK FACTOR FOR ARTIFICIAL URINARY SPHINCTER CUFF EROSION Matthias D Hofer, Kunj R Sheth, Timothy J Tausch, Jordan Siegel, Billy H Cordon, Nicholas L Kavoussi, Alexandra Klein, Claus G Roehrborn, and Allen F Morey Matthias D HoferMatthias D Hofer More articles by this author , Kunj R ShethKunj R Sheth More articles by this author , Timothy J TauschTimothy J Tausch More articles by this author , Jordan SiegelJordan Siegel More articles by this author , Billy H CordonBilly H Cordon More articles by this author , Nicholas L KavoussiNicholas L Kavoussi More articles by this author , Alexandra KleinAlexandra Klein More articles by this author , Claus G RoehrbornClaus G Roehrborn More articles by this author , and Allen F MoreyAllen F Morey More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1161AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In order to determine a possible relationship between hypogonadism and AUS cuff erosion, we evaluated the serum testosterone levels among men having artificial urinary sphincter (AUS) cuff erosions and compared these results to a cohort of uncomplicated AUS patients. METHODS After obtaining IRB approval, we reviewed 46 patients in whom serum testosterone levels were available and who received an AUS between 2007 and 2014. We defined hypogonadism as testosterone serum level <280 ng/dl. Mean follow-up was 2.96 years (range 1.01-7.67 years). Demographics of 18 patients with cuff erosion (39.1%) and 28 patients without erosion (60.9%) were similar with respect to cuff size, prior surgeries, radiation therapy, diabetes, or hypertension. Statistical analysis was performed with chi-square test, t-test, Kaplan-Meier analysis, and Cox regression analysis. RESULTS Of 18 AUS cuff erosions, 16 patients (88.9%) were hypogonadal compared to only 10 of 28 patients without cuff erosions (35%, p<0.001). Mean time to AUS erosion was 1.92 years (0.08-6.86 years). Cox regression analysis revealed that hypogonadism had a hazard ratio of 5.1 for AUS erosion compared to patients with normal testosterone levels (95% CI 1.1-22.6, p=0.003). Kaplan-Meier analysis demonstrated a significant decrease of erosion-free follow-up time in hypogonadal men compared to normogonadal men (log-rank p=0.018). There was no difference between hypogonadal and normogonadal men in respect to cuff size used, prior surgery, radiation therapy or comorbidities. Transcorporal placement was used more frequently in hypogonadal compared to normogonadal men (9/25 (36%) vs. 2/20 (10%), p=0.006). CONCLUSIONS Hypopgonadism in patients undergoing AUS implantation is a significant risk factor for subsequent cuff erosion. It is unknown whether testosterone supplementation prior to surgery would mitigate this almost unacceptable risk. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e397 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Matthias D Hofer More articles by this author Kunj R Sheth More articles by this author Timothy J Tausch More articles by this author Jordan Siegel More articles by this author Billy H Cordon More articles by this author Nicholas L Kavoussi More articles by this author Alexandra Klein More articles by this author Claus G Roehrborn More articles by this author Allen F Morey More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...