PD22-01 PREOPERATIVE CASTRATE LEVEL OF TESTOSTERONE DOES NOT IMPACT OUTCOMES AFTER AUS PLACEMENT

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) II (PD22)1 Sep 2021PD22-01 PREOPERATIVE CASTRATE LEVEL OF TESTOSTERONE DOES NOT IMPACT OUTCOMES AFTER AUS PLACEMENT Paula Domino, Nicole Benfante, Amy Tin, and Jaspreet Sandhu Paula DominoPaula Domino More articles by this author , Nicole BenfanteNicole Benfante More articles by this author , Amy TinAmy Tin More articles by this author , and Jaspreet SandhuJaspreet Sandhu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002011.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The impact of androgen deprivation therapy (ADT) on artificial urinary sphincter (AUS) outcomes is unclear, though relevant due to the increasing number of high risk patients undergoing prostatectomy. We determined the rate of the early complications - infection, urethral erosion, or re-implantation within 90 days of AUS placement - based on whether patients had ADT prior to AUS placement. We further determined whether re-implantation at any time is driven by ADT. METHODS: Patients who underwent a primary AUS between January 1996 and July 2020 with or without prior ADT and had adequate followup were identified. Early complications and the need and time to AUS reimplantation were recorded. We reported unadjusted rates of early complications based on prior ADT. We then assessed the association between time to AUS replacement and ADT use using a multivariable Cox regression with time to AUS replacement as the outcome and whether patients had ADT prior to AUS as the primary predictor, with age at initial AUS placement and history of radiation treatment prior to initial AUS placement as covariates. RESULTS: We identified 353 prostate cancer patients who underwent a primary AUS with adequate follow-up. Over a quarter (26%, n=91) had ADT before their AUS placement, of which 29 (32%) had metastatic prostate cancer. Six patients had early complications, with rates low in both groups, and we can exclude a large increase in rates associated with ADT: 2 cases (2.3%) in men with prior ADT versus 4 cases (1.6%) in men without ADT, difference = 0.8%, 95% C.I. 2.8%, 4.3%, p-value = 0.6. One-hundred and six patients had an AUS replacement during follow-up. The Kaplan Meier figure shows the estimated risk of replacement AUS based on whether patients underwent ADT prior to their initial AUS placement. We did not find evidence of a difference in time to replacement between groups on multivariable analysis (p=0.4). CONCLUSIONS: ADT or metastatic prostate cancer does not result in higher complications or re-operative rates and therefore should not be a deterrent to offering an AUS to these patients. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e380-e380 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Paula Domino More articles by this author Nicole Benfante More articles by this author Amy Tin More articles by this author Jaspreet Sandhu More articles by this author Expand All Advertisement Loading ...