Poster Session 10: Functional Urology

Introduction: There is a paucity of literature regarding the incidence of long-term urethral complications after prostate cancer treatment.Our objective was to assess the long-term incidence of urethral complications after different treatment modalities for prostate cancer.Methods: All men with a diagnosis of prostate cancer from 2002-2021 from the Alberta Cancer Registry were included.The Discharge Abstract Data (DAD) and the National Ambulatory Care Reporting System (NACRS) were searched for different treatment modalities and urologic diagnosis/procedures. Patients were allocated into six different groups: radical prostatectomy (RP), radiotherapy (RT), cryotherapy (Cryo), medical treatment/observation (MT/O), RP+RT, or Cryo+RT.Urethral complication was defined as development of stenosis, fistula, or a urethral/ bladder neck procedure >30 days after treatment (excluding TURP, diagnostic procedures, and incontinence).We compared the incidence of urethral complications among different groups using Cox regression Results: A total of 47 387 patients with prostate cancer diagnosis were identified, with a median age of 66 years (IQR 60-74); 3140 patients developed a urethral complication at a median followup of 76 months.Table 1 shows the cumulative incidence of urethral complications.On Kaplan-Meier analysis (Figure 1), urethral complication rate was different among groups (p<0,001).On multivariable Coxregression analysis including age (p<0.001) and stage p=0.002) at diagnosis, all treatment modalities (except for cryotherapy) were associated with development of urethral complications compared to MT/O.In particular, combined modalities such as RP+RT (HR 2.9, p<0,001) and RT+Cryo (HR 3.6, p<0.001) showed the highest risk.Complications after RP reached a plateau at 10 years, whereas other modalities continued to accumulate complications over the long-term.Conclusions: Patients undergoing prostate cancer treatment are at risk for developing urethral complications in the long-term regardless of treatment type.Specifically, combined modalities pose a heightened risk.