Clinical Risk Factors Associated With Urethral Atrophy

Boyd R. Viers, Shawn Mathur, Matthias D. Hofer, Daniel D. Dugi, Travis J. Pagliara, Nirmish Singla, Jordon Walker, Jeremy M. Scott, Allen F. Morey

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Abstract

Objective: To analyze a series of clinical risk factors associated with pretreatment urethral atrophy. Methods: We retrospectively reviewed 301 patients who underwent artificial urinary sphincter (AUS) placement between September 2009 and November 2015; of these, 60 (19.9%) transcorporal cuff patients were excluded. Patients were stratified into 2 groups based on intraoperative spongiosal circumference measurements. Men with urethral atrophy (3.5 cm cuff size) were compared to controls (≥4 cm cuff size). Chi-square test, Mann-Whitney . U test, and logistic regression analyses were performed to determine risk factors for urethral atrophy. Results: Among 241 AUS patients analyzed, urethral atrophy was present in 151 patients (62.7%) compared to 90 patients (37.3%) who received larger cuffs (range 4-5.5 cm). Patients with urethral atrophy were older (71.1years vs 68.3 years; . P < .02), more likely to have received radiation (52.9% vs. 33.3%; . P < .007), and had a longer time interval between prostate cancer treatment and AUS surgery (8.9 years vs. 6.6 years; . P < .033). On multivariable analysis, radiation therapy was independently associated with risk of urethral atrophy (odds ratio 1.77, 95% confidence interval: 1.01-3.13; . P = .046), whereas greater time between cancer therapy and incontinence surgery approached clinical significance (odds ratio 1.05, 95% confidence interval 1.00-1.09; . P = .05). Conclusion: History of radiation therapy and increasing length of time from prostate cancer treatment are associated with urethral atrophy before AUS placement.

Original languageEnglish (US)
JournalUrology
DOIs
StateAccepted/In press - Oct 25 2016

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ASJC Scopus subject areas

  • Urology

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Viers, B. R., Mathur, S., Hofer, M. D., Dugi, D. D., Pagliara, T. J., Singla, N., Walker, J., Scott, J. M., & Morey, A. F. (Accepted/In press). Clinical Risk Factors Associated With Urethral Atrophy. Urology. https://doi.org/10.1016/j.urology.2016.12.012