MP03-11 DOES RADIATION TIMING MATTER? ADJUVANT VS. SALVAGE RADIOTHERAPY EFFECTS ON ARTIFICIAL URINARY SPHINCTER SURVIVAL

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence (MP03)1 May 2024MP03-11 DOES RADIATION TIMING MATTER? ADJUVANT VS. SALVAGE RADIOTHERAPY EFFECTS ON ARTIFICIAL URINARY SPHINCTER SURVIVAL Tyler M. Gaines, Jeffrey C. Loh-Doyle, Marisa Maas, Emily Markarian, Austin Livingston, Logan Grimaud, Jordan Foreman, Aaron Lentz, Andrew Peterson, Roger Klein, John Myrga, Paul Rusilko, Joaquin Michel, Nicole Matluck, Billy Cordon, Mark Mikhail, Alex Hwang, Anand Shridharani, Liliya Tryfonyuk, Francisco Martins, Rebecca Gonzalez, Grant Van Der Voort, Rohan Bhalla, Brian Flynn, Dmitriy Nikolavsky, and Jay Simhan Tyler M. GainesTyler M. Gaines , Jeffrey C. Loh-DoyleJeffrey C. Loh-Doyle , Marisa MaasMarisa Maas , Emily MarkarianEmily Markarian , Austin LivingstonAustin Livingston , Logan GrimaudLogan Grimaud , Jordan ForemanJordan Foreman , Aaron LentzAaron Lentz , Andrew PetersonAndrew Peterson , Roger KleinRoger Klein , John MyrgaJohn Myrga , Paul RusilkoPaul Rusilko , Joaquin MichelJoaquin Michel , Nicole MatluckNicole Matluck , Billy CordonBilly Cordon , Mark MikhailMark Mikhail , Alex HwangAlex Hwang , Anand ShridharaniAnand Shridharani , Liliya TryfonyukLiliya Tryfonyuk , Francisco MartinsFrancisco Martins , Rebecca GonzalezRebecca Gonzalez , Grant Van Der VoortGrant Van Der Voort , Rohan BhallaRohan Bhalla , Brian FlynnBrian Flynn , Dmitriy NikolavskyDmitriy Nikolavsky , and Jay SimhanJay Simhan View All Author Informationhttps://doi.org/10.1097/01.JU.0001009488.55564.85.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Although radiation history is recognized as a significant risk factor for adverse outcomes following AUS implantation, this long-standing treatment remains the gold standard option for all male patients with refractory stress urinary incontinence (SUI). There remains limited - if any - data on the timing of radiation therapy in relation to outcomes following device implantation. Here, we compare artificial urinary sphincter (AUS) outcomes in post-prostatectomy patients who received radiotherapy in the adjuvant or salvage setting and hypothesize that patients who undergo salvage radiation have poorer overall AUS survivability. METHODS: A multicenter retrospective analysis was performed of post-prostatectomy patients with a history of radiation therapy in the adjuvant or salvage setting who also underwent AUS placement for SUI. Clinical characteristics, operative details and surgical outcomes were compared between patients who underwent adjuvant and salvage radiation and a critical analysis of AUS survivability was assessed for both radiation cohorts. RESULTS: A total of 221 patients met inclusion criteria. The adjuvant radiation cohort consisted of 93 patients (n=42%) and 128 patients (n=58%) underwent salvage radiation with a median follow-up of 26 and 34 months since AUS placement, respectively. Patients with a history of adjuvant therapy had longer interval from radiotherapy to AUS placement (90 v. 48 months, p<0.001). Operative details including total surgery time, incision type and urethral cuff size were similar between the two cohorts (p>0.05). Although overall rate of AUS erosion did not differ with respect to radiation timing (15% v. 18%, p=0.23), median time to AUS explantation was significantly shorter in the salvage cohort (18 v. 26.5 months, p=0.002, Figure 1). There was also a higher rate of post-explantation urethral strictures in patients who received salvage radiation (6/23 v. 1/14, p=0.034). CONCLUSIONS: This is the first multi-institutional series to critically demonstrate a shorter interval of AUS survivability in salvage radiation prostate cancer survivors compared to those with a history of adjuvant radiation. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e26 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Tyler M. Gaines More articles by this author Jeffrey C. Loh-Doyle More articles by this author Marisa Maas More articles by this author Emily Markarian More articles by this author Austin Livingston More articles by this author Logan Grimaud More articles by this author Jordan Foreman More articles by this author Aaron Lentz More articles by this author Andrew Peterson More articles by this author Roger Klein More articles by this author John Myrga More articles by this author Paul Rusilko More articles by this author Joaquin Michel More articles by this author Nicole Matluck More articles by this author Billy Cordon More articles by this author Mark Mikhail More articles by this author Alex Hwang More articles by this author Anand Shridharani More articles by this author Liliya Tryfonyuk More articles by this author Francisco Martins More articles by this author Rebecca Gonzalez More articles by this author Grant Van Der Voort More articles by this author Rohan Bhalla More articles by this author Brian Flynn More articles by this author Dmitriy Nikolavsky More articles by this author Jay Simhan More articles by this author Expand All Advertisement PDF downloadLoading ...