Membranous urethral length (MUL) in patients who have had male sling or artificial urinary sphincter surgery for bothersome post prostatectomy stress incontinence
BAUS ePoster online library. Faure Walker N. 06/21/21; 319097; p5-9
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Mr. Nicholas Faure Walker
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Abstract
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Introduction & objectives: Post-prostatectomy incontinence (PPI) is reported by 6.6-17% at one year after radical prostatectomy (RP). Membranous urethral length (MUL) is predictive of PPI. Whether MUL predicts PPI necessitating surgical intervention (male sling (MS) or artificial urinary sphincter (AUS) is unknown. We compare MUL in MS or AUS patients in a tertiary referral centre to controls who were continent at 12 months after RP.
Materials & methods: Men who underwent MS or AUS were prospectively identified. Baseline demographic and oncological data were recorded. MUL in sagittal and coronal planes (prostatic apex to penile bulb), urethral width and height, on T2 MRI were measured. Membranous urethral volume was estimated as an elipsoid cylinder. Means, standard deviations (SD) were calculated for normally distributed data; medians and ranges for non-normally distributed data.
Results: 95 patients (31 MS & 64 AUS) of which 26 had salvage radiotherapy, 4 were salvage RP's and 60 continent matched controls were identified. Median age, PSA & prostate volume (ml) of the AUS, MS and control groups were 65.4, 64.0 & 60.2 y (p=0.07); 8.6, 7.6 & 8.7 ng/ml (p=0.94); 33, 34.5 & 36ml (p=0.346). Distribution of T2,3&4 disease was similar between groups. MRI measurements are shown in the table.
Conclusions: The MUL and sphincter volumes of patients who had undergone MS & AUS were significantly smaller than in continent controls. None of the surgical group had MUL's over 17mm. This study shows smaller MUL length and volume puts patients at risk of PPI that requires surgery.
Materials & methods: Men who underwent MS or AUS were prospectively identified. Baseline demographic and oncological data were recorded. MUL in sagittal and coronal planes (prostatic apex to penile bulb), urethral width and height, on T2 MRI were measured. Membranous urethral volume was estimated as an elipsoid cylinder. Means, standard deviations (SD) were calculated for normally distributed data; medians and ranges for non-normally distributed data.
Results: 95 patients (31 MS & 64 AUS) of which 26 had salvage radiotherapy, 4 were salvage RP's and 60 continent matched controls were identified. Median age, PSA & prostate volume (ml) of the AUS, MS and control groups were 65.4, 64.0 & 60.2 y (p=0.07); 8.6, 7.6 & 8.7 ng/ml (p=0.94); 33, 34.5 & 36ml (p=0.346). Distribution of T2,3&4 disease was similar between groups. MRI measurements are shown in the table.
Conclusions: The MUL and sphincter volumes of patients who had undergone MS & AUS were significantly smaller than in continent controls. None of the surgical group had MUL's over 17mm. This study shows smaller MUL length and volume puts patients at risk of PPI that requires surgery.
Introduction & objectives: Post-prostatectomy incontinence (PPI) is reported by 6.6-17% at one year after radical prostatectomy (RP). Membranous urethral length (MUL) is predictive of PPI. Whether MUL predicts PPI necessitating surgical intervention (male sling (MS) or artificial urinary sphincter (AUS) is unknown. We compare MUL in MS or AUS patients in a tertiary referral centre to controls who were continent at 12 months after RP.
Materials & methods: Men who underwent MS or AUS were prospectively identified. Baseline demographic and oncological data were recorded. MUL in sagittal and coronal planes (prostatic apex to penile bulb), urethral width and height, on T2 MRI were measured. Membranous urethral volume was estimated as an elipsoid cylinder. Means, standard deviations (SD) were calculated for normally distributed data; medians and ranges for non-normally distributed data.
Results: 95 patients (31 MS & 64 AUS) of which 26 had salvage radiotherapy, 4 were salvage RP's and 60 continent matched controls were identified. Median age, PSA & prostate volume (ml) of the AUS, MS and control groups were 65.4, 64.0 & 60.2 y (p=0.07); 8.6, 7.6 & 8.7 ng/ml (p=0.94); 33, 34.5 & 36ml (p=0.346). Distribution of T2,3&4 disease was similar between groups. MRI measurements are shown in the table.
Conclusions: The MUL and sphincter volumes of patients who had undergone MS & AUS were significantly smaller than in continent controls. None of the surgical group had MUL's over 17mm. This study shows smaller MUL length and volume puts patients at risk of PPI that requires surgery.
Materials & methods: Men who underwent MS or AUS were prospectively identified. Baseline demographic and oncological data were recorded. MUL in sagittal and coronal planes (prostatic apex to penile bulb), urethral width and height, on T2 MRI were measured. Membranous urethral volume was estimated as an elipsoid cylinder. Means, standard deviations (SD) were calculated for normally distributed data; medians and ranges for non-normally distributed data.
Results: 95 patients (31 MS & 64 AUS) of which 26 had salvage radiotherapy, 4 were salvage RP's and 60 continent matched controls were identified. Median age, PSA & prostate volume (ml) of the AUS, MS and control groups were 65.4, 64.0 & 60.2 y (p=0.07); 8.6, 7.6 & 8.7 ng/ml (p=0.94); 33, 34.5 & 36ml (p=0.346). Distribution of T2,3&4 disease was similar between groups. MRI measurements are shown in the table.
Conclusions: The MUL and sphincter volumes of patients who had undergone MS & AUS were significantly smaller than in continent controls. None of the surgical group had MUL's over 17mm. This study shows smaller MUL length and volume puts patients at risk of PPI that requires surgery.
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