To evaluate the impact of an history of radiation therapy on the outcomes of artificial urinary sphincter (AUS) implantation in male patients.
The charts of all patients who underwent AUS implantation for stress urinary incontinence (SUI) after prostate surgery in thirteen centers between 2004 and 2020 were retrospectively reviewed. We excluded patients with neurogenic SUI. Continence rates and incidence of complications, revision and cuff erosion were evaluated. The outcomes in irradiated men were compared to those of non irradiated men.
A total of 1277 patients who had an AUS met the inclusion criteria with a median age of 70 years, of which 437 had an history of prior radiotherapy. There was no difference in comorbidities. In irradiated patients, postoperative social continence, urethral atrophy and infection rates were respectively 75.6%, 2.4% and 9.5% and 76.8%, 5.4%, and 5.8% in nonirradiated men (respectively, p = 0.799, p = 0.128, p = 0.148). There were more urethral erosion in irradiated male patients. After a mean follow up of 36.8 months, the explantation free survival was poorer in irradiated patients (p = 0.001).
These data suggest that pelvic radiotherapy before AUS adversely affect device survival with and increased greater occurrence of infection-erosion and therefore of explantation.
Neurourology and urodynamics. 2021 Nov 24 [Epub ahead of print]
Jordan Mamane, Stéphane Sanchez, Alexandre G Lellouch, Victor Gaillard, Baptiste Poussot, Thibault Tricard, Christian Saussine, Thibaut Brierre, Xavier Game, Florian Beraud, Xavier Biardeau, Franck Bruyere, Damien Robin, Mehdi El-Akri, Daniel Chevallier, Mathieu Durand, Imad Bentellis, Tiffany Cousin, Grégoire Capon, Jean-Nicolas Cornu, Hugo Dupuis, Hervé Monsaint, Luc Corbel, Nicolas Hermieu, Jean-Francois Hermieu, Alice Pitout, Pierre Lecoanet, Benoit Peyronnet, Priscilla Leon
Department of Urology, University of Reims, Reims, France., Department of Medical Information Evaluation and Performance, Troyes Hospital, Troyes, France., Department of Plastic Reconstructive Surgery, European Georges Pompidou Hospital, Paris, France., Department of Urology, University of Strasbourg, Strasbourg, France., Department of Urology, University of Toulouse, Toulouse, France., Department of Urology, University of Lille, Lille, France., Department of Urology, University of Tours, Tours, France., Department of Urology, University of Nice, Nice, France., Department of Urology, University of Rennes, Rennes, France., Department of Urology, University of Bordeaux, Bordeaux, France., Department of Urology, University of Rouen, Rouen, France., Department of Urology, Clinic Oceane, Vannes, France., Department of Urology, Clinic Plérin, Plérin, France., Department of Urology, Bichat Hospital, Paris, France., Department of Urology, University of Nancy, Nancy, France., Department of Urology, Clinic Pasteur, Royan, France.