Journal article
Outcomes and Risk Factors of Revision and Replacement Artificial Urinary Sphincter Implantation in Radiated and Nonradiated Cases
The Journal of urology, Vol.204(1), pp.110-114
07/01/2020
DOI: 10.1097/JU.0000000000000749
PMID: 31951498
Abstract
Purpose: Risk factors for complications after artificial urinary sphincter surgery include a history of pelvic radiation and prior artificial urinary sphincter complication. The survival of a second artificial urinary sphincter in the setting of prior device complication and radiation is not well described. We report the survival of redo artificial urinary sphincter surgery and identify risk factors for repeat complications.
Materials and Methods: A multi-institutional database was queried for redo artificial urinary sphincter surgeries. The primary outcome was median survival of a second and third artificial urinary sphincter in radiated and nonradiated cases. A Cox proportional hazards survival analysis was performed to identify additional patient and surgery risk factors.
Results: Median time to explantation of the initial artificial urinary sphincter in radiated (150) and nonradiated (174) cases was 26.4 and 35.6 months, respectively (p = 0.043). For a second device median time to explantation was 30.1 and 38.7 months (p = 0.034) and for a third device it was 28.5 and 30.6 months (p = 0.020), respectively. The 5-year revision-free survival for patients undergoing a second artificial urinary sphincter surgery with no risk factors, history of radiation, history of urethroplasty, and history of radiation and urethroplasty were 83.1%, 72.6%, 63.9% and 46%, respectively.
Conclusions: Patients without additional risk factors undergoing second and third artificial urinary sphincter surgeries experience revision-free rates similar to those of their initial artificial urinary sphincter devices. Patients who have been treated with pelvic radiation have earlier artificial urinary sphincter complications. When multiple risk factors exist, revision-free rates decrease significantly.
Details
- Title: Subtitle
- Outcomes and Risk Factors of Revision and Replacement Artificial Urinary Sphincter Implantation in Radiated and Nonradiated Cases
- Creators
- Thomas W. Fuller - University of California San DiegoEric Ballon-Landa - University of California San DiegoKelsey Gallo - University of California San DiegoThomas G. Smith - The University of Texas MD Anderson Cancer CenterDivya Ajay - The University of Texas MD Anderson Cancer CenterOuida L. Westney - The University of Texas MD Anderson Cancer CenterSean P. Elliott - University of MinnesotaNejd F. Alsikafi - UropartnersBenjamin N. Breyer - University of California, San FranciscoAndrew J. Cohen - University of California, San FranciscoAlex J. Vanni - Lahey Medical CenterJoshua A. Broghammer - University of KansasBrad A. Erickson - University of IowaJeremy B. Myers - University of UtahBryan B. Voelzke - Spokane UrologyLee C. Zhao - New York UniversityJill C. Buckley - University of California San Diego
- Resource Type
- Journal article
- Publication Details
- The Journal of urology, Vol.204(1), pp.110-114
- DOI
- 10.1097/JU.0000000000000749
- PMID
- 31951498
- NLM abbreviation
- J Urol
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 5
- Language
- English
- Date published
- 07/01/2020
- Academic Unit
- Urology
- Record Identifier
- 9984319993202771
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