Dr. Bassett presented the results from TURNS on urinary diversion after radiation for prostate cancer. Radiation treatment is used in 37 % of men diagnosed with prostate cancer, which equates to approximately 1 million men having undergone radiotherapy. There are many potential urologic complications and in some patients urinary diversion is required. The objective of this study was to establish the morbidity and mortality of urinary diversion after radiation therapy.
Nine sites from the TURNS group performed a retrospective review of 101 patients. Mean age of patients was 71, median time from radiation to diversion was 8 years and 100% of patients had a Charlson comorbidity score greater than 2. The majority had undergone combined surgical and radiation therapy for prostate cancer. 54% suffered from incontinence, 52% from urethral stricture and 45% from a fistula prior to diversion.
Of the 101 patients, 84% were diverted with an ileal conduit and 16% underwent creation of a catheterizable channel. The rate of major complications (Clavien grade 3) was 36% and 6% died. Early reoperation was necessary in 14% and late reoperation in 20%. The readmission rate was 38%.
They found no association between complications and age, type of radiation treatment or amount of radiation received, time between radiation and diversion and type of diversion. Interestingly, the rate of complications was decreased by 82% in overweight or obese men. They hypothesized that these patients may have had more nutritional reserve.
Presented by Mitchell Bassett (University of Utah) at the American Urological Association (AUA) Annual Meeting May 6-10, 2016 San Diego, CA
Reported by Lisa Parrillo (University of Pennsylvania) at the American Urological Association (AUA) Annual Meeting May 6-10, 2016 San Diego, CA