TY - JOUR
T1 - Low Serum Testosterone Level Predisposes to Artificial Urinary Sphincter Cuff Erosion
AU - Hofer, Matthias D.
AU - Morey, Allen
AU - Sheth, Kunj
AU - Tausch, Timothy J.
AU - Siegel, Jordan
AU - Cordon, Billy H.
AU - Bury, Matthew I.
AU - Cheng, Earl Y.
AU - Sharma, Arun K.
AU - Gonzalez, Chris M.
AU - Kaplan, William E.
AU - Kavoussi, Nicholas L.
AU - Klein, Alexandra
AU - Roehrborn, Claus
PY - 2016/11/1
Y1 - 2016/11/1
N2 - Objective To examine the association between decreased serum testosterone levels and artificial urinary sphincter (AUS) cuff erosion. Materials and Methods We evaluated serum testosterone levels in 53 consecutive patients. Low testosterone was defined as <280 ng/dL and found in 30/53 patients (56.6%). Chi-square and Student t tests, Kaplan-Meier analysis, binary logistic regression, and Cox regression analysis were used to determine statistical significance. Results Nearly all men with AUS cuff erosions had low serum testosterone (18/20, 90.0%) compared to those without erosions (12/33, 36.4%, P < .001). Mean time to erosion was 1.70 years (0.83-6.86); mean follow-up was 2.76 years (0.34-7.92). Low testosterone had a hazard ratio of 7.15 for erosion in a Cox regression analysis (95% confidence interval 1.64-31.17, P = .009) and Kaplan-Meier analysis demonstrated decreased erosion-free follow-up (log-rank P = .002). Low testosterone was the sole independent risk factor for erosion in a multivariable model including coronary artery disease and radiation (odds ratio 15.78; 95% confidence interval 2.77-89.92, P = .002). Notably, history of prior AUS, radiation, androgen ablation therapy, or concomitant penile implant did not confound risk of cuff erosion in men with low testosterone levels. Conclusion Men with low testosterone levels are at a significantly higher risk to experience AUS cuff erosion. Appropriate counseling before AUS implantation is warranted and it is unclear whether testosterone resupplementation will mitigate this risk.
AB - Objective To examine the association between decreased serum testosterone levels and artificial urinary sphincter (AUS) cuff erosion. Materials and Methods We evaluated serum testosterone levels in 53 consecutive patients. Low testosterone was defined as <280 ng/dL and found in 30/53 patients (56.6%). Chi-square and Student t tests, Kaplan-Meier analysis, binary logistic regression, and Cox regression analysis were used to determine statistical significance. Results Nearly all men with AUS cuff erosions had low serum testosterone (18/20, 90.0%) compared to those without erosions (12/33, 36.4%, P < .001). Mean time to erosion was 1.70 years (0.83-6.86); mean follow-up was 2.76 years (0.34-7.92). Low testosterone had a hazard ratio of 7.15 for erosion in a Cox regression analysis (95% confidence interval 1.64-31.17, P = .009) and Kaplan-Meier analysis demonstrated decreased erosion-free follow-up (log-rank P = .002). Low testosterone was the sole independent risk factor for erosion in a multivariable model including coronary artery disease and radiation (odds ratio 15.78; 95% confidence interval 2.77-89.92, P = .002). Notably, history of prior AUS, radiation, androgen ablation therapy, or concomitant penile implant did not confound risk of cuff erosion in men with low testosterone levels. Conclusion Men with low testosterone levels are at a significantly higher risk to experience AUS cuff erosion. Appropriate counseling before AUS implantation is warranted and it is unclear whether testosterone resupplementation will mitigate this risk.
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U2 - 10.1016/j.urology.2016.04.065
DO - 10.1016/j.urology.2016.04.065
M3 - Article
C2 - 27450351
AN - SCOPUS:84994666227
SN - 0090-4295
VL - 97
SP - 245
EP - 249
JO - Urology
JF - Urology
ER -