Pd44-08 Long-Term Morbidity Associated With Surgical Management of Urosymphyseal Fistula

You have accessJournal of UrologyReconstruction: Ureteral Reconstruction (Including Pyeloplasty) and Bladder Reconstruction (Including Trauma-Related Fistula) II (PD44)1 May 2024PD44-08 LONG-TERM MORBIDITY ASSOCIATED WITH SURGICAL MANAGEMENT OF UROSYMPHYSEAL FISTULA Alexandr M. Pinkhasov, Jayson Kemble, Anthony E. Fadel, Elizabeth Bearrick, and Boyd R. Viers Alexandr M. PinkhasovAlexandr M. Pinkhasov , Jayson KembleJayson Kemble , Anthony E. FadelAnthony E. Fadel , Elizabeth BearrickElizabeth Bearrick , and Boyd R. ViersBoyd R. Viers View All Author Informationhttps://doi.org/10.1097/01.JU.0001008800.83683.92.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urosymphyseal fistula (USF) is a profoundly debilitating disease process that is characterized by communication between the urinary tract (bladder or prostate) and pubic bone. Curative surgical therapy includes cystectomy with urinary diversion or fistula tract excision with bladder neck reconstruction, pubic bone debridement, and vascularized tissue flap interposition. There is a paucity of scientific literature regarding long-term outcomes for these patients. We aim to identify and characterize factors associated with long-term morbidity of definitive USF treatment. METHODS: Retrospective chart review of a single institution database identified 57 patients who underwent operative treatment of USF between 2009-2022 with>90 days of follow-up. Morbidity related to surgery was assessed up to 10 years postoperatively. Statistical analysis was performed using fishers exact and Mann Whitney-U tests. RESULTS: A total of 57 patients at a median age of 71 years old (IQR 66-75) presented with USF and ultimately underwent open 50 (88%) or robotic 7 (12%) repair. Delayed (>90 d) post operative complications requiring major intervention occurred at a median time of 11 months (IQR 6-18). Twelve (21%) patients required image-guided drain placement, 5 (9%) nephrostomy tubes, and 14 (24%) patients required additional surgery. Hernia was noted in 15 (26%) patients at a median time of 12 months (6-27). The use of omentum, VRAM, or no flap made no difference in hernia occurrence or the type of hernia (p>0.05). Pre-operative albumin of0.05). Ultimately, long-term pain resolved in 40 (70%), and 49 (86%) men were able to discontinue antibiotic therapy. CONCLUSIONS: While definitive USF repair is associated with long term morbidity including need for reintervention, hernia formation, recurrent infection, and SI fracture, most men are rendered free of infection and have significant improvement of life in quality following surgical treatment. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e908 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Alexandr M. Pinkhasov More articles by this author Jayson Kemble More articles by this author Anthony E. Fadel More articles by this author Elizabeth Bearrick More articles by this author Boyd R. Viers More articles by this author Expand All Advertisement PDF downloadLoading ...