Comparison of Adjuvant Radiation Therapy before or after Artificial Urinary Sphincter Placement: a Multi-Institutional, Retrospective Analysis

To determine if the timing of radiation therapy on artificial urinary sphincter (AUS) impacts complication rates, revision rates, and number of pads per day after placement.

A retrospective review was conducted of men with prostate cancer who underwent AUS placement and radiation therapy between 1987 and 2016.

Of 306 men, 292 (95.4%) received radiation before AUS placement (Group 1) and 14 (4.6%) received radiation after AUS placement (Group 2). Median follow-up was 30 months after AUS placement. Group 1 had 32/292 (11.0%) of patients suffer from erosion, compared to 0/14 (0.0%) of patients in Group 2 (p=0.191). None of the patients in Group 2 suffered from infection or mechanical failure. The number of patients who received revision in Group 1 was 91/292 (31.2%) and Group 2 was 2/14 (14.3%) (p=0.180). The number of pads used per day in Group 1 before and after AUS placement was 5.24 +/- 3.12 and 1.13 +/- 1.31, respectively (p<0.001). In Group 2, the number of pads used per day before and after AUS placement was 6.09 +/- 1.97 and 1.53+/-0.99, respectively (p<0.001). There was no significant difference in the average number of postoperative pads used per day between Group 1 and Group 2 (p=0.907).

The timing of radiation therapy does not appear to significantly affect complication rates or urinary continence, as measured in pads used post-AUS placement. This multi-institutional retrospective analysis showed similar erosion and revision rates when radiation occurred after AUS placement and demonstrates preliminary safety and feasibility of the administration of radiation after AUS placement.

Urology. 2017 Dec 06 [Epub ahead of print]

Kenneth J DeLay, Nora M Haney, Jason Chiang, Carrie Stewart, Faysal A Yafi, Kenneth Angermeier, Hadley Wood, Timothy Boone, Alex G Kavanagh, Matthew Gretzer, Stuart Boyd, Jeffrey C Loh-Doyle, Wayne J G Hellstrom

Department of Urology, Tulane University School of Medicine, New Orleans, LA., Department of Urology, University of California at Irvine, Orange, CA., Department of Urology, Cleveland Clinic Foundation, Cleveland, OH., Department of Urology, Houston Methodist Hospital, Houston, Texas, USA., Division of Urology, Department of Surgery, The University of Arizona, Tucson, AZ., Center for Genitourinary Reconstruction and Prosthetics, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California., Department of Urology, Tulane University School of Medicine, New Orleans, LA. Electronic address: .

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