Glickman Urological & Kidney Institute Outcomes

Cancer survivorship has always been an important component of the mission of the Center for Genitourinary Reconstruction. For the last 40 years the artificial urinary sphincter (AUS) has been the mainstay of treatment for men with significant urinary incontinence following radical prostatectomy for prostate cancer. Because many men are living longer with their disease, we recently looked at the use of the AUS in men being treated for biochemical recurrence (BR) or distant metastatic (DM) disease. Out of a cohort of 255 patients with sufficient follow-up data, 78 were treated with salvage androgen deprivation therapy: 27 (35%) of them before AUS, 32 (41%) starting near the time of AUS, and 19 (24%) after AUS. In this group 7 patients with cuff erosions and 6 patients with recurrent incontinence required surgery. Overall there was no significant difference in outcomes among patients who had no evidence of disease compared with those who had evidence of BR or DM. AUS durability was 85% to 90% at 5 years of follow-up indicating that men with recurrent disease on therapy remain good candidates for the procedure, which can provide meaningful improvement in quality of life.