PD24-07 FAILURE RATES OF BLADDER OUTLET SURGERIES FOR STRESS URINARY INCONTINENCE IN WOMEN WITH NEUROGENIC LOWER URINARY TRACT DYSFUNCTION: A MULTICENTER NEUROGENIC BLADDER RESEARCH GROUP STUDY DYSFUNCTION (NLUTD)

Abstract

You have accessJournal of UrologyCME1 May 2022PD24-07 FAILURE RATES OF BLADDER OUTLET SURGERIES FOR STRESS URINARY INCONTINENCE IN WOMEN WITH NEUROGENIC LOWER URINARY TRACT DYSFUNCTION: A MULTICENTER NEUROGENIC BLADDER RESEARCH GROUP STUDY DYSFUNCTION (NLUTD) Javier Santiago, Min Soo Choo, Anne Cameron, Richard Mora, Evgeniy Kreydin, David A Ginsberg, Natalia Hernandez, Paola Bustillos, Rose Khavari, Stephanie Daignault-Newton, and John Stoffel Javier SantiagoJavier Santiago More articles by this author , Min Soo ChooMin Soo Choo More articles by this author , Anne CameronAnne Cameron More articles by this author , Richard MoraRichard Mora More articles by this author , Evgeniy KreydinEvgeniy Kreydin More articles by this author , David A GinsbergDavid A Ginsberg More articles by this author , Natalia HernandezNatalia Hernandez More articles by this author , Paola BustillosPaola Bustillos More articles by this author , Rose KhavariRose Khavari More articles by this author , Stephanie Daignault-NewtonStephanie Daignault-Newton More articles by this author , and John StoffelJohn Stoffel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002566.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We evaluated the outcomes of bladder outlet procedures for treating stress urinary incontinence (SUI) in female patients with neurogenic lower urinary tract dysfunction (NLUTD). METHODS: A retrospective multi-institutional study by the Neurogenic Bladder Research Group of female patients with NLUTD and SUI who underwent urethral bulking injection (UBI), pubovaginal sling (PVS), or artificial urinary sphincter (AUS) for (SUI) from 2012-2020 was performed via CPT and ICD-9 codes. Women undergoing concomitant bladder reconstruction or botulinum toxin (BTX) were included. The primary outcome was failure of bladder outlet procedure defined as return to pre-operative baseline SUI symptoms and/or needing additional surgical intervention for SUI. Time to failure were evaluated and multi-variable analysis for variables associated with failure were assessed. RESULTS: Thirty-five female patients were included with diagnosis of spinal cord injury (35%), spina bifida (28%), and bladder exstrophy, multiple sclerosis or auto-immune neuropathy, pelvic surgery, or a supra-pontine disorder. There were 20, 14, and 1 cases of UBI, PVS, and AUS, respectively with a median follow up of 363 days. The median age was 46 years. BTX was performed exclusively with UBI (50%) and bladder reconstruction was performed more with sling vs UBI (29% vs 0%, p=0.02). Focusing on UBI and PVS, failure rates and time to failure between procedures were not significantly different on Kaplan Meier curves at median follow up of 5 and 14 months, respectively (75% failure at median 4.8 months for UBI vs 71% at 7.3 months for PVS, p=1). 6-month failure rates were 59% and 50% for UBI and PVS. Failure was only associated with increasing age on multivariable analysis. Additional surgeries for continence were performed in 60% and 57% patients after UBI and sling, respectively. CONCLUSIONS: Urethral bulking agents and sling placement both demonstrated similarly low durability in managing SUI in NLUTD in this cohort, with the majority of patients requiring secondary surgeries for continence. This warrants further study to better understand factors impacting failure. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e417 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Javier Santiago More articles by this author Min Soo Choo More articles by this author Anne Cameron More articles by this author Richard Mora More articles by this author Evgeniy Kreydin More articles by this author David A Ginsberg More articles by this author Natalia Hernandez More articles by this author Paola Bustillos More articles by this author Rose Khavari More articles by this author Stephanie Daignault-Newton More articles by this author John Stoffel More articles by this author Expand All Advertisement PDF DownloadLoading ...