Moderated Poster

Poster, Podium & Video Sessions

MP63-16: Effects of radiation on male stress incontinence

Sunday, May 14
3:30 PM - 5:30 PM
Location: BCEC: Room 153

Presentation Authors: Daniel Hoffman*, New York, NY, Benjamin Brucker, Nirit Rosenblum, New York , NY, Varun Vijay, New York, NY, Victor Nitti, New York , NY

Introduction: The aim of this study is assess the utility of preoperative urodynamic testing in men with stress urinary incontinence (SUI) and to identify urodynamic parameters that correlate to clinical variables and outcomes after surgery for SUI.

Methods: A retrospective chart review of all male patients with stress urinary incontinence (SUI) who underwent urodynamic testing (UDS) from 2010 until 2016 was performed. Clinical variables were correlated with urodynamic parameters such as maximum cystometric capacity (MCC), presence of detrusor overactivity (DO), and end filling pressure (EFP) as a measure of impaired compliance.

Results: 207 men were identified that underwent UDS with a presumed diagnosis of SUI. 73 (35.5%) men developed SUI after they underwent robotic prostatectomy, 48 (23.2%) had open prostatectomy, 21 (10.1%) had external beam radiotherapy (EBRT) only and 8 (3.9%) had brachytherapy. 41 (19.8%) had salvage radiotherapy. 65/207 (31.4%) were exposed to radiation as a treatment modality. All patients that underwent urodynamic testing moved on to surgical correction of SUI, 155 men had artificial urinary sphincter (AUS) and 52 men had male sling.
Table 1 and 2.

Conclusions: Radiation was predictive of having lower MCC (p=.03) and DO on UDS (p<0.0001) when compared to non-radiated (NR) men. Patients who have been radiated have a higher incidence of DO and high pressure DO(>40cmH20) when compared to NR men. Radiated patients with these urodynamic findings were associated to have increased need for anticholinergic use and progression to third line therapy. Interestingly, impaired compliance was not predictive. UDS did not change the decision to surgically treat SUI in any patient, however UDS may be helpful in counseling as having DO on UDS was predictive of requiring anticholinergic use post operatively (p=0.001) and having refractory OAB requiring third line therapy (p=0.01).

Source Of Funding: none

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