Indications for retroperitoneoscopic tumor nephrectomy are organ-confined renal tumors, stage T1-(2). Large tumor size is only a relative contraindication, which depends on the comfort level of the surgeon and the individual characteristics of the tumor. Contraindications include vena caval thrombus, bulky lymphadenopathy, locally invasive tumors, and previous excessive lumbal surgery. The patient reports to the hospital 1 day before surgery and undergoes routine preoperative evaluation including blood analysis, chest X-ray, and electrocardiography. Special bowel preparation is not necessary for retroperitoneoscopy. To prevent thrombosis the patient receives subcutaneous low-molecular-weight heparin on the evening before the operation. One hour preoperatively broad-spectrum antibiotics are administered intravenously. Following general anesthesia and Foley catheter placement, the patient is safely secured to the operating table in a standard full-flank position.

Typically, a living donor is either an immediate blood-related family member or a spouse of the recipient who has end-stage renal failure. Recently, altruistic third-party donation has gained considerable attention. All potential donors are routinely evaluated according to a donation protocol. Their suitability is discussed in detail by the transplantation team comprising nephrologist, urologist, visceral and vascular surgeon, transplantation coordinators, immunological laboratories, and psychosomatic experts. Preoperatively, contrast-enhanced magnet resonance angiography (MRA) is performed to evaluate the vascular anatomy in all donors. The left kidney is preferred for donor nephrectomy because of the longer left renal vein, which facilitates the implantation process. There is consensus that the ‘better’ kidney should always remain with the donor, so that in case of certain anatomic conditions such as multiple arteries, venous anomalies, vascular stenosis or an early arterial branching the right kidney needs to be harvested.

PDF file, 46K, Analysis of the expression of ALDH specific isoforms in BPH and PCa surgical specimens.

PDF file, 1824K, Differential expression and localization of ALDH1A1 and ALDH7A1 proteins in BPH.

Aims To assess efficacy and safety as well as predictive factors of dry rate and freedom from surgical revision in patients underwent AUS placement. The artificial urinary sphincter (AUS) is still considered the standard for the treatment of moderate to severe post-prostatectomy stress urinary incontinence (SUI). However, data reporting efficacy and safety from large series are lacking. Methods A multicenter, retrospective study was conducted in 16 centers in Europe and USA. Only primary cases of AUS implantation in non-neurogenic SUI after prostate surgery, with a follow-up of at least 1 year were included. Efficacy data (continence rate, based on pad usage) and safety data (revision rate in case of infection and erosion, as well as atrophy or mechanical failure) were collected. Multivariable analyses were performed in order to investigate possible predictors of the aforementioned outcomes. Results Eight hundred ninety-two men had primary AUS implantation. At 32 months mean follow-up overall dry rate and surgical revision were 58% and 30.7%, respectively. Logistic regression analysis showed that patients without previous incontinence surgery had a higher probability to be dry after AUS implantation (OR: 0.51, P = 0.03). Moreover institutional case-load was positively associated with dry rate (OR: 1.18; P = 0.005) and freedom from revision (OR: 1.51; P = 0.00). Conclusions The results of this study showed that AUS is an effective option for the treatment of SUI after prostate surgery. Moreover previous incontinence surgery and low institutional case-load are negatively associated to efficacy and safety outcomes.

Inflammation has been suggested to play an important role in onset and progression of prostate cancer (PCa). Histological analysis of prostatectomy specimens has revealed focal inflammation in early stage lesions of this malignancy. We addressed the role of inflammatory stimuli in the release of PCa-specific, tumor-derived soluble factors (PCa-TDSFs) already reported to be mediators of PCa morbidity, such as indoleamine 2,3-dioxygenase (IDO) and interleukin (IL)-6. Inflammation-driven production and functions of PCa-TDFSs were tested “in vitro” by stimulating established cell lines (CA-HPV-10 and PC3) with IFN-γ or TNF-α. Expression of genes encoding IDO, IL-6, IFN-γ, TNF-α, and their receptors was investigated in tumor tissues of PCa patients undergoing radical prostatectomy, in comparison with benign prostatic hyperplasia (BPH) specimens. IFN-γ and TNF-α-treatment resulted in the induction of IDO and IL-6 gene expression and release in established cell lines, suggesting that the elicitation of PCa-TDSFs by these cytokines might contribute to progression of cancer into an untreatable phenotype. An analysis based on timing of biochemical recurrence revealed the prognostic value of IDO but not IL-6 gene expression in predicting recurrence-free survival in patients (RFS) with PCa. In addition, a urine-based mRNA biomarker study revealed the diagnostic potential of IDO gene expression in urines of men at risk of PCa development.

In 2018, owing to the variety of true minimally invasive and effective treatment modalities available, early surgery in patients suffering from lower urinary tract symptoms due to benign prostatic enlargement is a valid, safe, and effective option compared to long-term less effective medical treatment.

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence: Therapy1 Apr 2017MP46-09 PREVIOUS INCONTINENCE SURGERY AND SURGICAL VOLUME PREDICT SOCIAL CONTINENCE AND SURGICAL REVISION: RESULTS OF A LARGE MULTI-INSTITUTIONAL STUDY. Manuela Tutolo, Giulia Castagna, Enrico Ammirati, Marcus Drake, Nikseh Tiruchelvam, Kari Tikkinen, Alexander Bachmann, Ignacio Martinez-Salamanca, Giorgio Bozzini, Ricarda Bauer, John Heesakkers, Michele Favro, Richard Lee, Stéphane Larré, Cosimo De Nunzio, François Haab, Sascha Ahyai, Thomas Pichon, Jean-Nicolas Cornu, and Frank Van Der Aa Manuela TutoloManuela Tutolo More articles by this author , Giulia CastagnaGiulia Castagna More articles by this author , Enrico AmmiratiEnrico Ammirati More articles by this author , Marcus DrakeMarcus Drake More articles by this author , Nikseh TiruchelvamNikseh Tiruchelvam More articles by this author , Kari TikkinenKari Tikkinen More articles by this author , Alexander BachmannAlexander Bachmann More articles by this author , Ignacio Martinez-SalamancaIgnacio Martinez-Salamanca More articles by this author , Giorgio BozziniGiorgio Bozzini More articles by this author , Ricarda BauerRicarda Bauer More articles by this author , John HeesakkersJohn Heesakkers More articles by this author , Michele FavroMichele Favro More articles by this author , Richard LeeRichard Lee More articles by this author , Stéphane LarréStéphane Larré More articles by this author , Cosimo De NunzioCosimo De Nunzio More articles by this author , François HaabFrançois Haab More articles by this author , Sascha AhyaiSascha Ahyai More articles by this author , Thomas PichonThomas Pichon More articles by this author , Jean-Nicolas CornuJean-Nicolas Cornu More articles by this author , and Frank Van Der AaFrank Van Der Aa More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1448AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Artificial urinary sphincter (AUS) is considered the gold standard for moderate-to-severe male SUI. The aim of our study is to assess efficacy and safety in a large multi-institutional cohort of patients with long follow-up (FU) and to build a model to assess predictive factors of social continence (SC) and surgical revision (SR). METHODS The study included 892 patients from 16 tertiary referral centres, submitted to primary AUS implant, between 1993 and 2012, with a minimum FU of 1-year. Patients were evaluated at 1, 6 and 12 months after surgery and yearly thereafter. SC was defined as 1 security pad or less and SR as any further surgery for failure or complications. To identify predictors of SC and SR we accounted for the following variables: age, diabetes mellitus (DM), anticoagulation therapy (AC), previous incontinence surgery (PIS), radiotherapy (RT), double cuff (DC), cuff size (CS) and surgical volume (SV). Patients were sub-divided into two groups according to the median number of implants per center/year (most informative cut-off), to define low and high SV centres. We also evaluated complication rate (CR): erosions and infections and failure rate (FR): urethral atrophy and mechanical failures. RESULTS Overall 126/892 (14.1%) previously underwent TURP and 766 (85.9%) RP: the two groups differ only in terms of DM and AC (all p<0.05). Mean FU was 32 months (median 20, range 12-300); A total of 218/892 (24.4%) patients had PIS, namely: male sling surgery (n=75, 8.4%), peri-urethral injections (n=50; 5.6%) or peri-urethral balloons (n=92, 10.4%). Overall 257/892 (28.9%) patients had adjuvant RT. The median number of implants-per centre/year resulted to be 4: according to this cut-off value, 303 patients (34%) resulted to be treated in low-volume and 589 (66%) in high-volume centres. Erosion and infections were observed in 60/892 patients (6.7%) and 38/892 (4.2%) respectively. Urethral atrophy and mechanical failures were observed in 32/892 (3.5%) and 121/892 (13.5%), respectively. Overall SC and SR rates were 55% (n=489) and 30.6% (n=273) respectively. Multivariable analysis showed PIS to be the only predictor of lower SC rate (OR: 1.49, p=0.02) and SV the only variable associated with a higher risk of SR (OR: 1.53; p=0.016). CONCLUSIONS Our large-cohort long-FU study, confirms AUS as gold standard for post-op SUI. However it is still associated with high SR rates. PIS resulted to be negatively associated with SC. The results concerning SV confirm previous studies reporting no plateau for learning curve, with reduction of revisions only after 200 procedures. These results represent a further step in counselling and treatment of SUI after prostatic surgery. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e622 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Manuela Tutolo More articles by this author Giulia Castagna More articles by this author Enrico Ammirati More articles by this author Marcus Drake More articles by this author Nikseh Tiruchelvam More articles by this author Kari Tikkinen More articles by this author Alexander Bachmann More articles by this author Ignacio Martinez-Salamanca More articles by this author Giorgio Bozzini More articles by this author Ricarda Bauer More articles by this author John Heesakkers More articles by this author Michele Favro More articles by this author Richard Lee More articles by this author Stéphane Larré More articles by this author Cosimo De Nunzio More articles by this author François Haab More articles by this author Sascha Ahyai More articles by this author Thomas Pichon More articles by this author Jean-Nicolas Cornu More articles by this author Frank Van Der Aa More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Context: Several noninvasive tests have been developed for diagnosing bladder outlet obstruction (BOO) in men to avoid the burden and morbidity associated with invasive urodynamics. The diagnostic accuracy of these tests, however, remains uncertain.Objective: To systematically review available evidence regarding the diagnostic accuracy of noninvasive tests in diagnosing BOO in men with lower urinary tract symptoms (LUTS) using a pressure-flow study as the reference standard.Evidence acquisition: The EMBASE, MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Central, Google Scholar, and WHO International Clinical Trials Registry Platform Search Portal databases were searched up to May 18, 2016. All studies reporting diagnostic accuracy for noninvasive tests for BOO or detrusor underactivity in men with LUTS compared to pressure-flow studies were included. Two reviewers independently screened all articles, searched the reference lists of retrieved articles, and performed the data extraction. The quality of evidence and risk of bias were assessed using the QUADAS-2 tool.Evidence synthesis: The search yielded 2774 potentially relevant reports. After screening titles and abstracts, 53 reports were retrieved for full-text screening, of which 42 (recruiting a total of 4444 patients) were eligible. Overall, the results were predominantly based on findings from nonrandomised experimental studies and, within the limits of such study designs, the quality of evidence was typically moderate across the literature. Differences in noninvasive test threshold values and variations in the urodynamic definition of BOO between studies limited the comparability of the data.Detrusor wall thickness (median sensitivity 82%, specificity 92%), near- infrared spectroscopy (median sensitivity 85%, specificity 87%), and the penile cuff test (median sensitivity 88%, specificity 75%) were all found to have high sensitivity and specificity in diagnosing BOO. Uroflowmetry with a maximum flow rate of <10 ml/s was reported to have lower median sensitivity and specificity of 68% and 70%, respectively. Intravesical prostatic protrusion of > 10 mm was reported to have similar diagnostic accuracy, with median sensitivity of 68% and specificity of 75%.Conclusions: According to the literature, a number of noninvasive tests have high sensitivity and specificity in diagnosing BOO in men. However, although the majority of studies have a low overall risk of bias, the available evidence is limited by heterogeneity. While several tests have shown promising results regarding noninvasive assessment of BOO, invasive urodynamics remain the gold standard.Patient summary: Urodynamics is an accurate but potentially uncomfortable test for patients in diagnosing bladder problems such as obstruction. We performed a thorough and comprehensive review of the literature to determine if there were less uncomfortable but equally effective alternatives to urodynamics for diagnosing bladder problems. We found that some simple tests appear to be promising, although they are not as accurate. Further research is needed before these tests are routinely used in place of urodynamics. (C) 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

To evaluate oncologic parameters of men with bothersome LUTS undergoing surgical treatment with HoLEP or TURP.

Using a population-based cohort, data from 50,598 patients treated with radical prostatectomy and pelvic lymph node dissection were used to externally validate our pathologic nodal staging score model. This model allows for quantification of the likelihood that a pathologically node-negative patient will not have lymph node metastasis after surgery. Background: We sought to externally validate our pathologic nodal staging score (pNSS) model, which allows for quantification of the likelihood that a pathologically node-negative patient will not have lymph node (LN) metastasis after radical prostatectomy for prostate cancer (PCa) in a population-based cohort. Patients and Methods: We analyzed data from 50,598 patients treated with radical prostatectomy and pelvic LN dissection using the Surveillance, Epidemiology, and End Results database. We estimated the sensitivity of pathologic nodal staging using a beta-binomial model and developed a novel pNSS model, which represents the probability that a patient's PCa has been correctly staged as node negative as a function of the number of examined LNs. These findings were compared against those from the original cohort of 7135 patients. Results: The mean and median number of LNs removed was 6.5 and 5, respectively (range, 1-89; interquartile range, 2-8), and 96.9% of the patients (n = 49,020) had stage pN0. Similar to the original cohort, the probability of missing a positive LN decreased with the increasing number of LNs examined. In both the validation and the original cohort, the number of LNs needed to correctly stage a patient's disease as node negative increased with more advanced tumor stage, higher Gleason sum, positive surgical margins, and higher preoperative prostate-specific antigen levels. Conclusion: We have confirmed that the number of examined LNs needed for adequate nodal staging in PCa depends on the pathologic tumor stage, Gleason sum, surgical margins status, and preoperative prostate-specific antigen. We externally validated our pNSS in a population-based cohort, which could help to refine decision-making regarding the administration of adjuvant therapy. (C) 2017 Elsevier Inc. All rights reserved.

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia II1 Apr 2016MP36-09 PREDICTING BACTERIURIA PRIOR TO GREENLIGHT LASERVAPORISATION OF THE PROSTATE - ACCURACY OF DIPSTICK URINE ANALYSIS AND URINE FLOW CYTOMETRY Gernot Bonkat, Helge Seifert, Armin Halla, Georg Müller, Adrian Egli, Axel Regineter, Thomas Gasser, Alexander Bachmann, and Malte Rieken Gernot BonkatGernot Bonkat More articles by this author , Helge SeifertHelge Seifert More articles by this author , Armin HallaArmin Halla More articles by this author , Georg MüllerGeorg Müller More articles by this author , Adrian EgliAdrian Egli More articles by this author , Axel RegineterAxel Regineter More articles by this author , Thomas GasserThomas Gasser More articles by this author , Alexander BachmannAlexander Bachmann More articles by this author , and Malte RiekenMalte Rieken More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1643AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urine cultures (UC) are recommended prior to transurethral prostate surgery such as GreenLight laservaporisation of the prostate (GLV) to rule out bacteriuria. However, UC has a typical time delay of 24-48 hours between sample acquisition, pathogen identification and delivery of antimicrobial susceptibility testing results. The aim of our study was to determine the diagnostic accuracy of dipstick testing and urine flow cytometry to predict bacteriuria in patients undergoing GreenLight laservaporisation of the prostate. METHODS Retrospective analysis of 567 urine samples from 458 patients who underwent GLV with the 180-W XPS laser for benign prostatic obstruction between 04/2010 and 08/2015. Urine samples were obtained via clean catch (MSSU) technique 1 to 28 days prior to GLV. In patients with an indwelling transurethral catheter urine specimens were obtained after catheter removal via a freshly placed catheter. Specimens were sent for conventional culture (UC), urine flow cytometry (UFC) and automated dipstick analysis (DA). Results of UC were interpreted according to the European Urinalysis Guideline. UFC was performed using the Sysmex 1000i (TOA Medical Electronics, Kobe, Japan), DA by automated Roche Atlas Urisys System (Roche Diagnostics, Basel, Switzerland), respectively. Sensitivity and specificity of UFC and DA in predicting bacteriuria were compared to UC. Statistical analyses were performed with SPSS, version 20.0. RESULTS Overall, UC culture, UFC and DA were positive in 22%, 52% and 53% of the cases, respectively. Samples obtained via MSSU were positive in 12%, 28% and 33% compared to 35%, 84% and 81% of specimens obtained from patients with indwelling catheter. In MSSU cases, the sensitivity and specificity of UFC (86% and 80%) were significantly (p<0.05) higher compared to DA (84% and 74%). In specimens obtained from patients with indwelling catheter, the sensitivity and specificity of UFC (98% and 24%) and automated DA (95% and 27%) were comparable and showed no statistically significant difference. In patients with a positive UC obtained by MSSU, Enterococcus spp. (26%), Escherichia coli (22%), and Pseudomonas aeruginosa (12%) were most commonly detected. In contrast, in patients with indwelling catheter, Enterococcus spp. (26%), Escherichia coli (14%), and Enterobacteriaceae not otherwise specified (11%) were the most frequent detected pathogens. CONCLUSIONS Urine flow cytometry may be recommended to rule out bacteriuria in patients prior to GLV without indwelling catheter. Due to high sensitivity and high specificity, obtaining a urine culture may be regarded as unnecessary in patients with negative urine samples. In patients with indwelling transurethral catheters, urologists should ensure that the results of urine cultures are available prior to GLV. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e492 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Gernot Bonkat More articles by this author Helge Seifert More articles by this author Armin Halla More articles by this author Georg Müller More articles by this author Adrian Egli More articles by this author Axel Regineter More articles by this author Thomas Gasser More articles by this author Alexander Bachmann More articles by this author Malte Rieken More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

OBJECTIVE To characterize the safety and efficacy of the 180-W XPS-Greenlight laser in patients on systemic anticoagulation. MATERIALS AND METHODS A retrospective analysis of 384 patients who underwent photoselective vaporization of the prostate with the 180-W XPS-laser between 2010 and 2013 at two centers in the United States and Switzerland was performed. The primary outcome was the intraoperative and postoperative complication rates for those on anticoagulation undergoing photoselective vaporization of the prostate. The secondary outcome was International Prostate Symptom Scores, postvoid residual, maximum flow rate, and prostate-specific antigen levels. RESULTS Of 384 patients, aspirin, clopidogrel, and warfarin were used in 146 (38%), 34 (8.9%), and 57 (14.8%) patients, respectively. Single-drug, two-drug, and three-drug combinations were used in 142 (35.5%), 37 (9.3%), and 7 (1.7%) of the cases. Median lasing time (39 min vs 36 min; P = .99) and number of fibers used (1.0 vs 1.0; P = .63) were comparable between patients on vs off systemic anticoagulation. Postoperatively, urinary symptoms (International Prostate Symptom Score, quality of life) and objective voiding parameters (maximum flow rate, postvoid residual) improved in both groups of patients. During a maximum follow-up of 2 years, patients on vs off systemic anticoagulation did not show any significant differences in the rate of postoperative urinary tract infection (3.8% vs 5.1%; P = .71), retention (5.1% vs 5.9%; P = .71), urethral stricture (1.5% vs none, P = .05), and reoperation (2.2% vs 1.5%; P = .49). The primary limitation is the retrospective nature of the study. CONCLUSION Photovaporization of the prostate with the 180-W XPS-laser is a safe and effective minimal-invasive treatment option for patients on systemic anticoagulation. (C) 2016 Elsevier Inc.

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence: Therapy I1 Apr 2016MP87-17 ADJUVANT RADIOTHERAPY HAS NO IMPACT ON DRY RATE AND SURGICAL REVISION RATE AFTER ARTIFICIAL URINARY SPHINCTER IMPLANTATION FOR STRESS URINARY INCONTINENCE AFTER RADICAL PROSTATECTOMY Manuela Tutolo, Giulia Castagna, Marcus J. Drake, Nikseh Tiruchelvam, Kari A.O. Tikkinen, Alexander Bachmann, Juan I. Martinez-Salamanca, Giorgio Bozzini, Ricarda M. Bauer, John Heesakkers, Michele Favro, Richard K. Lee, Stéphane Larré, Cosimo De Nunzio, François Haab, Sascha A. Ahyai, Thomas Pichon, Jean-Nicolas Cornu, and Frank Van Der Aa Manuela TutoloManuela Tutolo More articles by this author , Giulia CastagnaGiulia Castagna More articles by this author , Marcus J. DrakeMarcus J. Drake More articles by this author , Nikseh TiruchelvamNikseh Tiruchelvam More articles by this author , Kari A.O. TikkinenKari A.O. Tikkinen More articles by this author , Alexander BachmannAlexander Bachmann More articles by this author , Juan I. Martinez-SalamancaJuan I. Martinez-Salamanca More articles by this author , Giorgio BozziniGiorgio Bozzini More articles by this author , Ricarda M. BauerRicarda M. Bauer More articles by this author , John HeesakkersJohn Heesakkers More articles by this author , Michele FavroMichele Favro More articles by this author , Richard K. LeeRichard K. Lee More articles by this author , Stéphane LarréStéphane Larré More articles by this author , Cosimo De NunzioCosimo De Nunzio More articles by this author , François HaabFrançois Haab More articles by this author , Sascha A. AhyaiSascha A. Ahyai More articles by this author , Thomas PichonThomas Pichon More articles by this author , Jean-Nicolas CornuJean-Nicolas Cornu More articles by this author , and Frank Van Der AaFrank Van Der Aa More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2367AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Artificial urinary sphincter (AUS) implantation has a high success rate in the treatment of post prostatectomy incontinence. Typically, 30/40% of men receiving AUS after RP, have also undergone adjuvant radiotherapy (RT). Literature is ambiguous, with some series defining RT as a risk factors and others as irrelevant. The aim of our study was to investigate in a large multi institutional database whether adjuvant RT had a significant impact on dry rate (DR) and surgical revision (SR) rate outcomes after AUS placement in this group of patients. METHODS Our Multi-institutional study was conducted on 916 men, implanted with AUS for SUI after RP, between 1993 and 2012 in 15 European and 1 American reference centers. For study aims, outcomes of patients who did or did not undergo adjuvant RT (RT vs controls) were compared; data on DR and SR rate were collected and compared. Chi-square and Wilcoxon rank tests were used to compare the outcomes between groups. RESULTS Overall 266/916 (29%) patients underwent adjuvant RT. Mean follow up period was 30 months (median 20.4; range 0.5-269). No statistically significant differences were found between the 2 groups in terms of age, diabetes mellitus, anticoagulant intake, smoking, previous surgery and follow up period. The comparative analysis showed no statistically significant differences in DR or SR in RT vs controls group (p=0.37 vs 0.40 respectively). CONCLUSIONS Literature is still ambiguous on the effect of RT on AUS dry rate and surgical revision rate; on the other hand, the majority of studies underlines that RT increases the risk of re-intervention after AUS implantation. To our knowledge this is the largest cohort assessing the impact of RT on AUS outcomes. We could not demonstrate a significant impact of adjuvant RT on DR nor on SR rate. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1121 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Manuela Tutolo More articles by this author Giulia Castagna More articles by this author Marcus J. Drake More articles by this author Nikseh Tiruchelvam More articles by this author Kari A.O. Tikkinen More articles by this author Alexander Bachmann More articles by this author Juan I. Martinez-Salamanca More articles by this author Giorgio Bozzini More articles by this author Ricarda M. Bauer More articles by this author John Heesakkers More articles by this author Michele Favro More articles by this author Richard K. Lee More articles by this author Stéphane Larré More articles by this author Cosimo De Nunzio More articles by this author François Haab More articles by this author Sascha A. Ahyai More articles by this author Thomas Pichon More articles by this author Jean-Nicolas Cornu More articles by this author Frank Van Der Aa More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence: Therapy I1 Apr 2016MP87-07 DIABETES MELLITUS AND ANTICOAGULANT THERAPY DO NOT INFLUENCE DRY RATE OR SURGICAL REVISION RATE AFTER ARTIFICIAL URINARY SPHINCTER IMPLANTATION FOR POST PROSTATECTOMY INCONTINENCE – RESULTS OF A MULTI-INSTITUTIONAL STUDY Manuela Tutolo, Giulia Castagna, Marcus J. Drake, Nikseh Tiruchelvam, Kari A.O. Tikkinen, Alexander Bachmann, Juan I. Martinez-Salamanca, Giorgio Bozzini, Ricarda M. Bauer, John Heesakkers, Michele Favro, Richard K. Lee, Stéphane Larré, Cosimo De Nunzio, François Haab, Sascha A. Ahyai, Thomas Pichon, Frank Van Der Aa, and Jean-Nicolas Cornu Manuela TutoloManuela Tutolo More articles by this author , Giulia CastagnaGiulia Castagna More articles by this author , Marcus J. DrakeMarcus J. Drake More articles by this author , Nikseh TiruchelvamNikseh Tiruchelvam More articles by this author , Kari A.O. TikkinenKari A.O. Tikkinen More articles by this author , Alexander BachmannAlexander Bachmann More articles by this author , Juan I. Martinez-SalamancaJuan I. Martinez-Salamanca More articles by this author , Giorgio BozziniGiorgio Bozzini More articles by this author , Ricarda M. BauerRicarda M. Bauer More articles by this author , John HeesakkersJohn Heesakkers More articles by this author , Michele FavroMichele Favro More articles by this author , Richard K. LeeRichard K. Lee More articles by this author , Stéphane LarréStéphane Larré More articles by this author , Cosimo De NunzioCosimo De Nunzio More articles by this author , François HaabFrançois Haab More articles by this author , Sascha A. AhyaiSascha A. Ahyai More articles by this author , Thomas PichonThomas Pichon More articles by this author , Frank Van Der AaFrank Van Der Aa More articles by this author , and Jean-Nicolas CornuJean-Nicolas Cornu More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2357AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Artificial urinary sphincters (AUS) are the gold standard for the surgical treatment of post prostatectomy incontinence. High revision rates remain the Achilles heel of this therapy. Diabetes mellitus (DM) is a known risk factor for prosthesis infection. Additionally, it can be associated with voiding disorders. Anticoagulant therapy (AC) is a known risk factor for bleeding complications, which in turn, can lead to infection and erosion. Very few data are available on their correlation with AUS outcomes. In our multi institutional study we investigated whether DM, or AC have a significant impact on dry rate (DR) and surgical revision (SR) rate in patients treated with AUS after radical prostatectomy (RP). METHODS We retrospectively analyzed the charts of 916 patients from 15 European centers and 1 American center. All patients underwent surgery between 1993 and 2012. For study purposes patient with DM (DM) and healthy patients (noDM) were compared. A second comparison was made in terms of AC therapy (AC vs no AC). Chi-square and Wilcoxon rank tests were used to compare the DR and SR between groups. RESULTS No baseline differences were present between the different studied groups in terms of Age, previous surgery and Time to follow up (mean 2,26 yrs vs 2,76 yrs in DM vs NoDM, respectively) and (2.76 yrs vs 2.84 yrs in AC vs noAC), (all p>0.05). Mean follow up period was 30 months (median 20.4; range 0.5-269). Data on DM were available on 818 pt, and, of them 113 (12,3%) had DM. The presence of DM had no significant impact on SR rate or DR (p= 0.34 and p=0.22 respectively). Data on AC were available on 815 pt, and, of them 94 (11,5%) had took AC. No difference was found also when comparing the AC groups in terms of SR and DR (all p> 0.005). CONCLUSIONS The presence of AC or DM is not associated with decreased DR or increased SR after AUS implant in our large multicenter cohort study. Patients on AC or with DM can be counseled likewise in clinical practice. The large number of patients, multicenter design and adequate follow up strengthen these findings. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1117 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Manuela Tutolo More articles by this author Giulia Castagna More articles by this author Marcus J. Drake More articles by this author Nikseh Tiruchelvam More articles by this author Kari A.O. Tikkinen More articles by this author Alexander Bachmann More articles by this author Juan I. Martinez-Salamanca More articles by this author Giorgio Bozzini More articles by this author Ricarda M. Bauer More articles by this author John Heesakkers More articles by this author Michele Favro More articles by this author Richard K. Lee More articles by this author Stéphane Larré More articles by this author Cosimo De Nunzio More articles by this author François Haab More articles by this author Sascha A. Ahyai More articles by this author Thomas Pichon More articles by this author Frank Van Der Aa More articles by this author Jean-Nicolas Cornu More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...