Prior Radiation Therapy is Associated With Increased Risk of Intraoperative Complications in Patients Undergoing...

Area of Science:

• Urology
• Surgical Outcomes
• Radiation Oncology

Background:

• Pelvic radiation therapy (RT) is a common treatment for various pelvic malignancies.
• The impact of prior RT on outcomes following inflatable penile prosthesis (IPP) implantation is not fully understood.
• Understanding these outcomes is crucial for patient counseling and surgical planning.

Purpose of the Study:

• To compare intraoperative and postoperative outcomes of primary IPP implantation in patients with and without a history of pelvic RT.
• To identify specific complications associated with prior RT in this patient population.

Main Methods:

• A multicenter, retrospective analysis of 3530 patients undergoing primary IPP placement (July 2016 - July 2021).
• 211 patients with prior RT were compared to a matched cohort of non-irradiated patients using 1:1 propensity score matching.
• Statistical analysis included Chi-square, Mann-Whitney U tests, multivariable logistic regression, and Kaplan-Meier analysis.

Main Results:

• Patients with prior RT exhibited higher intraoperative complication rates (4.3% vs 0.9%, P=.032), notably distal crossover events (1.9% vs 0%, P=.044).
• Prior RT in the context of radical prostatectomy and diabetes mellitus were independently associated with increased intraoperative complications.
• No significant differences were found in postoperative complications or reoperation rates at 24 months.

Conclusions:

• A history of pelvic RT is a significant risk factor for intraoperative complications during primary IPP implantation.
• Despite increased intraoperative risks, postoperative outcomes and reoperation rates are comparable to patients without prior RT.
• These findings highlight the need for careful surgical technique in irradiated patients but suggest similar long-term functional outcomes.