MP46-17 PATIENT-REPORTED URINARY CONTINENCE FOLLOWING SALVAGE WHOLE GLAND PROSTATE CRYOABLATION: OUTCOMES AT THE 1-YEAR POST-SALVAGE INTERVAL (2021)

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy (MP46)1 Sep 2021MP46-17 PATIENT-REPORTED URINARY CONTINENCE FOLLOWING SALVAGE WHOLE GLAND PROSTATE CRYOABLATION: OUTCOMES AT THE 1-YEAR POST-SALVAGE INTERVAL Ahmed Elshafei, Al Ray, Ahmed O. Khalifa, Wade Muncey, Austin Fernstrum, Michael Callegari, Megan Prunty, Rashed Ghandou, Adam Calaway, Jonathan Shoag, J. Stephen Jones, Thomas Polascik, and Lee Ponsky Ahmed ElshafeiAhmed Elshafei More articles by this author , Al RayAl Ray More articles by this author , Ahmed O. KhalifaAhmed O. Khalifa More articles by this author , Wade MunceyWade Muncey More articles by this author , Austin FernstrumAustin Fernstrum More articles by this author , Michael CallegariMichael Callegari More articles by this author , Megan PruntyMegan Prunty More articles by this author , Rashed GhandouRashed Ghandou More articles by this author , Adam CalawayAdam Calaway More articles by this author , Jonathan ShoagJonathan Shoag More articles by this author , J. Stephen JonesJ. Stephen Jones More articles by this author , Thomas PolascikThomas Polascik More articles by this author , and Lee PonskyLee Ponsky More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002067.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To assess patient-reported rates of urinary continence 12 months following salvage whole gland cryoablation for radio recurrent prostate cancer. METHODS: We reviewed 927 patients treated with salvage cryoablation for radio recurrent prostate cancer. The primary endpoint was to report the change in the rate of urinary continence at two different time periods (0-9 months and 10-14 months) following cryosurgery. The secondary endpoint of analysis was to assess the independent predictors of postoperative urinary continence at the established time intervals. Continence was defined as strictly pad- free (0 Pads). RESULTS: Of 927 men, 55 were excluded who had urinary incontinence prior to salvage cryotherapy. Mean age was 70.1 years (SD±6.9), mean PSA was 8.1 ng/ml (SD±11.5) and radio recurrent Gleason Grade Group (GGG) >2 disease was identified in 554/809 (68.5%) men with mean follow-up time of 45.4 months (SD±50.5). Overall, 297/872 (34.1%) patients had early urinary incontinence between 0-9 months after salvage cryoablation, compared to 134/872 (15.4 %) from 10-14 months (p<0.0001), with relative risk reduction of incontinence being 55%. By multivariate analysis, neoadjuvant androgen deprivation therapy (NADT) (OR 0.65, p=0.013), pretreatment GGG >2 disease (OR 1.87, p<0.001), prior interventional BPH therapy (OR 4.84, p<0.001) and postoperative urinary retention (OR. 3.05, p<0.001) were all independent predictors of Post-Cryo incontinence within the first 9 months. The independent predictors for Post-Cryo incontinence at the one-year (10-14 months) interval were smaller prostate volume (TPV) (OR 0.97, p=0.02) and post-ablation urinary retention (OR 3.25, p<0.001). CONCLUSIONS: To the best of our knowledge this is the first study reporting changes in the rate of urinary continence over time following salvage whole gland cryoablation. Urinary function was significantly improved by the one-year time interval following therapy with a 55% reduction in the incontinence rate compared to the 0-9 month time period. NADT, higher pretreatment GGG, prior interventional BPH therapy and post-salvage urinary retention were independent predictors of short-term incontinence following prostate salvage cryoablation. Men with smaller TPV and those who had post-salvage urinary retention were at increased risk of having urinary incontinence approximately 1 year following salvage cryotherapy. These clinical factors should be taken into consideration when counselling men failing radiation prior to salvage cryosurgery. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e820-e820 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ahmed Elshafei More articles by this author Al Ray More articles by this author Ahmed O. Khalifa More articles by this author Wade Muncey More articles by this author Austin Fernstrum More articles by this author Michael Callegari More articles by this author Megan Prunty More articles by this author Rashed Ghandou More articles by this author Adam Calaway More articles by this author Jonathan Shoag More articles by this author J. Stephen Jones More articles by this author Thomas Polascik More articles by this author Lee Ponsky More articles by this author Expand All Advertisement Loading ...