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Artificial sphincter insertion after radiotherapy: is it worthwhile?

A Manunta1, F Guillé, J J Patard

  • 1Department of Urology, Centre Hospitalier Universitaire Pontchaillou, Rennes, France.

BJU International
|February 26, 2000
PubMed
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Artificial urinary sphincter implantation in patients with prior pelvic radiotherapy leads to higher complication and re-operation rates. Patients should be counseled on these increased risks before undergoing artificial urinary sphincter surgery.

Area of Science:

  • Urology
  • Surgical Oncology
  • Radiation Oncology

Background:

  • Pelvic radiotherapy is a common treatment for various cancers.
  • Artificial urinary sphincter (AUS) implantation is a standard treatment for stress urinary incontinence (SUI).
  • The impact of prior pelvic radiotherapy on AUS outcomes is not well-established.

Purpose of the Study:

  • To evaluate the outcomes of artificial urinary sphincter implantation in men with a history of pelvic radiotherapy.
  • To compare complication rates and continence rates between irradiated and non-irradiated patients.

Main Methods:

  • Retrospective review of 72 men who underwent AUS implantation.
  • Detailed analysis of 15 patients with a history of pelvic radiotherapy.
  • Comparison of complication rates (re-operation, infection) and functional outcomes (continence).

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Main Results:

  • The complication rate was significantly higher in the radiotherapy group (8/15 re-operations, 3 infections).
  • Continence was achieved in 11/15 (73%) of the irradiated patients.
  • In the non-irradiated group, 51/57 (89%) achieved continence.

Conclusions:

  • Artificial urinary sphincter implantation is feasible after pelvic radiotherapy but associated with increased risks.
  • Patients with prior pelvic radiotherapy face a higher likelihood of complications and revision surgery.
  • Informed consent should include discussion of the elevated risks for patients with a history of pelvic radiotherapy.