Mp03-08 Rates of Surgical Management and Repeat Procedures for Stress Urinary Incontinence Following Radical Prostatectomy in the United States

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence (MP03)1 May 2024MP03-08 RATES OF SURGICAL MANAGEMENT AND REPEAT PROCEDURES FOR STRESS URINARY INCONTINENCE FOLLOWING RADICAL PROSTATECTOMY IN THE UNITED STATES Leo D. Dreyfuss, Ethan Weitzman, Adithya Balasubramanian, Camilo Arenas-Gallo, Stephen Rhodes, Xian Wu, Richard Lee, and Jonathan Shoag Leo D. DreyfussLeo D. Dreyfuss , Ethan WeitzmanEthan Weitzman , Adithya BalasubramanianAdithya Balasubramanian , Camilo Arenas-GalloCamilo Arenas-Gallo , Stephen RhodesStephen Rhodes , Xian WuXian Wu , Richard LeeRichard Lee , and Jonathan ShoagJonathan Shoag View All Author Informationhttps://doi.org/10.1097/01.JU.0001009488.55564.85.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Stress urinary incontinence (SUI) following radical prostatectomy (RP) is common. While most men regain urinary continence within 1 year following RP, surgical management is indicated for those with persistent SUI despite conservative measures. We evaluated surgical treatment rates for SUI following RP in the United States. METHODS: A population-based retrospective cohort study was performed using the IBM MarketScan Commercial and Medicare Claims and Encounters Database. Men who underwent RP between 2012 and 2021 with at least 1 year of continuous enrollment were included. Men with a diagnosis of incontinence, bladder cancer, prior or concurrent cystectomy, or history of radiotherapy prior to RP were excluded. Procedure codes were used to identify surgery for SUI following RP. Multivariable Cox proportional hazards models were used to identify predictors of surgery for SUI and were adjusted for age and year of RP. The primary outcome was rates of SUI surgery following RP, and secondary outcome was rates of repeat SUI surgery. RESULTS: RP was performed in 41,194 men with a mean age of 59.6 years. Mean (SD) Charlson Comorbidity Index (CCI) was 2.6 (1.3). Open RP was performed in 13.9% of men and 18.4% had salvage radiotherapy (RT). Median follow-up was 2.8 years. A diagnosis of SUI was identified in 27.9% of men. Overall, 1,219 (3.0%) of men underwent surgery for SUI, including 1.1% artificial urinary sphincter (AUS), 1.5% urethral slings, and 0.4% urethral bulking. Median time to surgery for SUI was 1.7 years overall, 1.8 years for AUS, 1.6 years for slings, and 1.4 years for bulking agents (Figure 1). Of men with at least 3 years of follow-up following RP, only post-operative RT was significantly associated with index SUI surgery (adjusted HR 1.6, 95% CI 1.25-1.79). Repeat surgery for SUI was performed in 78 men, including 0.65% of men who underwent AUS, 6.6% of men who underwent slings, and 23.8% of men who underwent bulking. CONCLUSIONS: Surgery for SUI is rare despite high rates of urinary incontinence following RP. Urethral slings and bulking agents are associated with higher re-treatment rates. Men seeking the highest chance of definitive surgery for SUI may be best served with AUS placement. Download PPT Source of Funding: JS is supported by the Frederick J. and Theresa Dow Fund of the New York Community Trust, the Vinney Scholars Award, and a Damon Runyon Cancer Research Foundation Physician Scientist Training Award © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e25 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Leo D. Dreyfuss More articles by this author Ethan Weitzman More articles by this author Adithya Balasubramanian More articles by this author Camilo Arenas-Gallo More articles by this author Stephen Rhodes More articles by this author Xian Wu More articles by this author Richard Lee More articles by this author Jonathan Shoag More articles by this author Expand All Advertisement PDF downloadLoading ...