PD41-12 RESECTION OF PUBIC SYMPHYSIS WITH CYSTECTOMY AND URINARY DIVERSION IMPROVES LONG TERM PATIENT REPORTED PHYSICAL HEALTH MEASURES AMONG PATIENTS WITH UROSYMPHYSEAL FISTULA

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion II (PD41)1 Apr 2020PD41-12 RESECTION OF PUBIC SYMPHYSIS WITH CYSTECTOMY AND URINARY DIVERSION IMPROVES LONG TERM PATIENT REPORTED PHYSICAL HEALTH MEASURES AMONG PATIENTS WITH UROSYMPHYSEAL FISTULA William R Boysen*, Brian Inouye, and Andrew C Peterson William R Boysen*William R Boysen* More articles by this author , Brian InouyeBrian Inouye More articles by this author , and Andrew C PetersonAndrew C Peterson More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000921.012AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Fistulization from the urinary tract to the pubic symphysis with resultant osteomyelitis is a devastating complication of prostate cancer treatment. Surgical management with removal of the pubic symphysis and infected bone at time of cystectomy and urinary diversion can cure the associated pain and chronic infection. However, the impact of this radical surgery on physical and mental function is unknown. We hypothesized that patient reported physical and mental function would improve following surgery. METHODS: We identified patients who underwent cystectomy with urinary diversion and pubic symphysectomy for urosymphyseal fistula at our facility. The validated Short Form 12 (SF-12) questionnaire generates a physical composite score (PCS) and mental health composite score (MCS) ranging from 0 to 100, which can be compared to population means for a given age group. The SF-12 was administered at most recent clinic follow up, as well as preoperatively to a subset of patients. Statistical analyses included descriptive statistics and Mann-Whitney U-test. RESULTS: Twelve men completed post-operative SF-12, with a mean age of 70.3 years at time of surgery and mean follow up of 16.2 months. All patients had resection of pubic symphysis at time of cystectomy with urinary diversion. Four patients completed the SF-12 preoperatively. The mean PCS preoperatively was 25.4, and improved to 43.3 postoperatively (p=0.02, figure 1). The preoperative PCS was significantly less than the national average of 44.9 for men in this age group (p=0.01), while the postoperative PCS did not differ from the national average (p=1.0). The mean MCS preoperatively was 42.3, and improved to 51.8 postoperatively (p=0.07, figure 1). The preoperative MCS was significantly less than the national average of 54.8 for men in this age group (p=0.013), while the postoperative PCS did not differ from the national average (p=0.12). CONCLUSIONS: Despite resection of the pubic symphysis, radical surgery for urosymphyseal fistula results in improved physical function scores. Preoperative physical and mental function scores are well below the national average, but following surgery both return to the population average for men of the same age. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e826-e826 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information William R Boysen* More articles by this author Brian Inouye More articles by this author Andrew C Peterson More articles by this author Expand All Advertisement PDF downloadLoading ...