PD35-06 PRE-EXISTING HYPOGONADISM DOES NOT IMPACT SURGICAL OUTCOMES FOLLOWING PRIMARY URETHROPLASTY

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You have accessJournal of UrologyCME1 Apr 2023PD35-06 PRE-EXISTING HYPOGONADISM DOES NOT IMPACT SURGICAL OUTCOMES FOLLOWING PRIMARY URETHROPLASTY Matthew Shneyderman, Andrew Gabrielson, Logan Galansky, and Andrew Cohen Matthew ShneydermanMatthew Shneyderman More articles by this author , Andrew GabrielsonAndrew Gabrielson More articles by this author , Logan GalanskyLogan Galansky More articles by this author , and Andrew CohenAndrew Cohen More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003333.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Decreased urethral vascularity due to a hypogonadal state may be a risk factor for complications following urethroplasty (UP). We compare reoperation and surgical site infection (SSI) rates among patients with hypogonadism with or without testosterone replacement therapy (TRT) prior to first UP. METHODS: A retrospective cohort study was conducted using the TriNetX research network between 2006-2022. Hypogonadal patients needed a diagnosis of hypogonadism and confirmatory T level <300 ng/dL preceding UP. We defined 4 groups: 1) Eugonadal patients undergoing UP 2) Hypogonadal patients with and without TRT, 3) Hypogonadal patients receiving TRT prior to UP, 4) Hypogonadal patients without TRT prior to UP. Propensity-score matching was used to adjust for differences in comorbidities listed in Table 1. Outcomes were 5-year rates and revision-free survival (RFS) for endoscopic (dilation, DVIU), surgical (repeat UP), and all-cause revision (endoscopic or surgical revision), as well as SSI within 90 days. RESULTS: We identified 12,556 eugonadal patients and 488 hypogonadal patients (147 [30%] with TRT, 341 [70%] without TRT) undergoing UP. Median age at UP and follow-up time was 55 years and 5 years, respectively. Comparing the propensity-score matched cohort of eugonadal patients to all hypogonadal patients, there was no difference in 90-day SSI (2.7% vs. 2.5%), nor were there differences in 5-year all-cause (19.4% vs. 19.6%), endoscopic (12.4% vs. 11.5%), or surgical revision (8.9% vs. 11.8%) [all p>0.05] (Table 1). Kaplan-Meier analysis found no difference in 5-year RFS rate for all-cause, endoscopic, or surgical revision (all log-rank p>0.05). Comparing hypogonadal patients who received TRT prior to UP versus hypogonadal patients who did not receive TRT, we found no difference in 5-year rates and RFS for all-cause (22.4% vs. 17.9%), endoscopic (11.6% vs. 11.2%), and surgical revision (14.3% vs. 9.7%) [all p>0.05] (Table 1). Post-UP, 83 (56%) patients in the TRT arm received additional TRT, whereas only 23 (6.7%) patients in the non-TRT arm received new TRT. CONCLUSIONS: Pre-existing hypogonadism does not appear to be an adverse predictor of surgical outcomes following primary urethroplasty based on data from a large, retrospective cohort study. Source of Funding: NA © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e976 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matthew Shneyderman More articles by this author Andrew Gabrielson More articles by this author Logan Galansky More articles by this author Andrew Cohen More articles by this author Expand All Advertisement PDF downloadLoading ...