Prior Radiation Therapy Decreases Time to Idiopathic Erosion of Artificial Urinary Sphincter: A Multi-Institutional Analysis
| Autor: | Joshua A. Broghammer, Mario A. Cleves, Niels V. Johnsen, LeRoy Jones, Martin S. Gross, Gerard D. Henry, Douglas F. Milam, Jeffrey D. Brady, William O. Brant, Melissa R. Kaufman |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Time Factors Urinary Incontinence Stress Urology medicine.medical_treatment Brachytherapy 030232 urology & nephrology Artificial urinary sphincter Young Adult 03 medical and health sciences 0302 clinical medicine medicine Humans External beam radiotherapy Prior Radiation Therapy Aged Retrospective Studies Aged 80 and over Prostatectomy 030219 obstetrics & reproductive medicine Radiotherapy business.industry Urethral sphincter Prostatic Neoplasms Middle Aged Prosthesis Failure Surgery Radiation therapy Treatment Outcome Urethra medicine.anatomical_structure Urinary Sphincter Artificial business Radical retropubic prostatectomy |
| Zdroj: | Journal of Urology. 199:1037-1041 |
| ISSN: | 1527-3792 0022-5347 |
| Popis: | Substantial controversy and conflicting data exist regarding the survival of the artificial urinary sphincter in patients with prior radiation therapy. We present data from a multi-institutional analysis examining the effect of prior radiation for prostate cancer on device survival.A database was compiled of patients with artificial urinary sphincter cuff erosion, which included demographic and comorbid patient characteristics, functional analyses and interventions. We identified 80 patients with iatrogenic or idiopathic artificial urinary sphincter erosion. Idiopathic erosion cases were further analyzed to determine factors influencing device survival with specific stratification for radiation therapy.A total of 56 patients were identified with idiopathic artificial urinary sphincter erosion. Of those men 33 (58.9%) had not undergone radiation treatment while 23 (41.1%) had a history of brachytherapy or external beam radiotherapy. In patients without radiation erosion-free median device survival was 3.15 years (95% CI 1.95-5.80), in contrast to the median device survival of only 1.00 year (95% CI 0.36-3.00) in irradiated patients. The erosion-free survival experience of patients with vs without radiation differed significantly (Wilcoxon-Breslow test for equality of survivor functions p = 0.03).Radiation therapy in patients with known idiopathic cuff erosion in this contemporary analysis correlated with significantly increased time to erosion. Mean time to idiopathic cuff erosion was accelerated by approximately 2 years in irradiated cases. To our knowledge these data represent the first demonstration of substantial outcome differences associated with radiation in patients with an artificial urinary sphincter who present specifically with cuff erosion. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|