Durability of Artificial Urinary Sphincter With Prior Radiation Therapy

The data on the effect of prior radiation therapy on the durability of artificial urinary sphicter lacks consistency and long-term follow-up. We found no significant difference in incontinence rates or rates of revision, erosion, infection, and removal of artificial urinary sphicter with or without prior radiation therapy in our study comprising 94 men at a median follow-up of 62 months. Background The aim of this study was to investigate the effect of prior radiation therapy on artificial urinary sphincter. Methods Group 1 was comprised of 63 men who underwent prior radical prostatectomy, and Group 2 was comprised of 31 men who received prior radiation therapy with or without prior radical prostatectomy. Social incontinence was defined as requiring to use > 1 pad per day and/or catheter-dependent at the time of last follow-up. Results The median age at artificial urinary sphincter placement was 71 years (interquartile range, 55-74 years). The median and mean follow-up was 62 months (interquartile range, 37-106 months) and 75 months (range, 2-205 months), respectively. At the time of last follow-up, 67% (63 of 94) of the men in the entire cohort (73% [46 of 63] and 55% [17 of 31] in Group 1 and Group 2, respectively [P = .078]) were socially continent. Sphincter revision, erosion, infection, and removal rates were 20%, 20%, 7%, and 10%, respectively, in Group 1, and 26%, 13%, 7%, and 23%, respectively, in Group 2. The differences in these rates were not statistically significant between the 2 groups. Conclusion We found no significant difference in functionality (incontinence rates) and outcomes (rates of sphincter revision, erosion, infection, and removal) between the 2 groups. The message for patients is that prior radiation does not significantly alter the outcomes of artificial urinary sphincter.