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MP46-07 MULTICENTER ANALYSIS OF ARTIFICIAL URINARY SPHINCTER OUTCOMES IN PATIENTS AFTER BOTH RADICAL PROSTATECTOMY AND ANASTOMOTIC URETHROPLASTY
Abstract   Open access   Peer reviewed

MP46-07 MULTICENTER ANALYSIS OF ARTIFICIAL URINARY SPHINCTER OUTCOMES IN PATIENTS AFTER BOTH RADICAL PROSTATECTOMY AND ANASTOMOTIC URETHROPLASTY

Jonathan Wingate, Jeremy Myers, Gregory Murphy, Nejd Alsikafi, Bradley Erickson, Benjamin Breyer and Bryan Voelzke
The Journal of urology, Vol.197(4S), pp.e621-e621
04/2017
DOI: 10.1016/j.juro.2017.02.1446
url
https://doi.org/10.1016/j.juro.2017.02.1446View
Published (Version of record) Open Access

Abstract

INTRODUCTION AND OBJECTIVES We sought to assess artificial urinary sphincter (AUS) outcomes in a subset of patients who have had a history of radical prostatectomy and anastomotic urethroplasty in order to describe outcomes after having two prior urethral transecting surgeries. Our null hypothesis is that multiple transections of the urethra do not increase the possibility of urethral erosion following artificial urinary sphincter placement. METHODS We performed a retrospective review from five participating centers in the Trauma and Urologic Reconstruction Network of Surgeons. The study period included February 2010 - January 2016. Of the 445 incontinence procedures in our prospective database, there were 35 patients who underwent an AUS and had both a radical prostatectomy and anastomotic urethroplasty. Patients were excluded if they did not have a minimum of 6 months of follow up after AUS placement. Twenty-two patients met inclusion criteria. The surgeon independently determined choice of transcorporal or standard cuff technique. RESULTS Median age was 67.5 years. Mean follow up time was 32.2 months (IQR 16.6 - 44.6 months). Twelve patients had a history of prior pelvic radiation for prostate cancer. Of the 22 patients, twenty patients had transcorporal cuff placement. There were 7 complications - 2 erosions, 3 hematomas, 1 infection, and 1 pump migration. Of these complications, four required additional surgery - the two erosions underwent AUS removal, one hematoma required exploration, and the patient with pump migration had his pump location adjusted. The overall AUS in situ rate in our cohort was 90.9% (20/22). History of prior radiation was not associated with AUS complications (p = 0.23). CONCLUSIONS AUS implantation can be performed in patients after two urethral transecting surgeries with an in situ rate of 90.9% at medium term follow up. Surgeons appear to prefer transcorporal placement in these scenarios.

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