PD31-03 BLADDER OUTLET SURGERIES FOR MEN WITH STRESS URINARY INCONTINENCE AND NEUROGENIC LOWER URINARY TRACT DYSFUNCTION: A MULTICENTER NEUROGENIC BLADDER RESEARCH GROUP STUDY

Abstract

You have accessJournal of UrologyCME1 May 2022PD31-03 BLADDER OUTLET SURGERIES FOR MEN WITH STRESS URINARY INCONTINENCE AND NEUROGENIC LOWER URINARY TRACT DYSFUNCTION: A MULTICENTER NEUROGENIC BLADDER RESEARCH GROUP STUDY Javier Santiago, Min Soo Choo, 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 , 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.0000000000002582.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We evaluated the effectiveness and durability of bladder outlet procedures for treating stress urinary incontinence (SUI) in male patients with neurogenic lower urinary tract dysfunction (NLUTD). METHODS: A retrospective multi-institutional review by the Neurogenic Bladder Research Group of male patients with NLUTD who underwent urethral bulking injection (UBI), sling placement, or artificial urinary sphincter (AUS) for SUI between 2012-2020 was performed via CPT and ICD-9 codes. Men undergoing concomitant bladder reconstruction or botulinum injections (BTX) were included. The primary outcome was procedural failure, defined as return to baseline pre-operative 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: Forty-five men were identified with diagnosis of spina bifida (SB) (60%), spinal cord injury (SCI) (15%), and bladder exstrophy, multiple sclerosis or auto-immune neuropathy, pelvic surgery, or a supra-pontine disorder. Bladder outlet procedures included 17, 13, and 15 cases of UBI, sling, and AUS, respectively with a median follow up of 627 days. The mean age was 33 years, and AUS had significantly older patients (mean age 50) compared to sling (20) and UBI (27) (p=0.0003). Concomitant BTX was performed exclusively with UBI (17%) and bladder reconstruction was performed more with sling vs UBI (53% vs 11%, p=0.019). AUS demonstrated the longest overall failure-free survival (Figure 1) with a failure rate of 27%, followed by sling (43%) and UBI (76%) (p=0.016). UBI was notable for rapid failure within 6 months (49.8%) compared to sling (23%) and AUS (13%). Failure was associated with increasing age, with UBI and sling compared to AUS, and SCI diagnosis (compared to SB) on multi-variable analysis. CONCLUSIONS: Men with NLUTD and SUI had longer failure free survival with artificial urinary sphincter compared to sling and bulking agents in this multi-institutional cohort. This data can be used for counseling patients on expectations associated with bladder outlet procedures in this population. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e541 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 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 ...