Clinical Risk Factors Associated With Urethral Atrophy

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

Research output: Contribution to journalArticle

4 Citations (Scopus)

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
Externally publishedYes

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Atrophy
Artificial Urinary Sphincter
Prostatic Neoplasms
Radiotherapy
Odds Ratio
Confidence Intervals
Chi-Square Distribution
Therapeutics
Logistic Models
Regression Analysis
Radiation
Neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

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

Clinical Risk Factors Associated With Urethral Atrophy. / Viers, Boyd R.; Mathur, Shawn; Hofer, Matthias D.; Dugi, Daniel; Pagliara, Travis J.; Singla, Nirmish; Walker, Jordon; Scott, Jeremy M.; Morey, Allen F.

In: Urology, 25.10.2016.

Research output: Contribution to journalArticle

Viers, BR, Mathur, S, Hofer, MD, Dugi, D, Pagliara, TJ, Singla, N, Walker, J, Scott, JM & Morey, AF 2016, 'Clinical Risk Factors Associated With Urethral Atrophy', Urology. https://doi.org/10.1016/j.urology.2016.12.012
Viers BR, Mathur S, Hofer MD, Dugi D, Pagliara TJ, Singla N et al. Clinical Risk Factors Associated With Urethral Atrophy. Urology. 2016 Oct 25. https://doi.org/10.1016/j.urology.2016.12.012
Viers, Boyd R. ; Mathur, Shawn ; Hofer, Matthias D. ; Dugi, Daniel ; Pagliara, Travis J. ; Singla, Nirmish ; Walker, Jordon ; Scott, Jeremy M. ; Morey, Allen F. / Clinical Risk Factors Associated With Urethral Atrophy. In: Urology. 2016.
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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.",
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N2 - 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.

AB - 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.

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