Page 2 - CUA 2020_Sexual Dysfunction and Transplant

2020 CUA Abstracts

References thral injury (PFUI) urethroplasty outcomes and to determine risk factors
1. Canadian Cancer Statistics Advisory Committee. Canadian Cancer for complications.
Statistics 2019. Toronto; 2019. Methods: A total of 119 patients who had undergone reconstruction
2. Rini BI, Campbell SC, Escudier B. Renal cell carcinoma. Lancet for PFUI at our center from 1998–2018 were identified using billing
2009;373:1119-32. https://doi.org/10.1016/S0140-6736(09)60229-4 codes. Descriptive statistics were completed and used to compare the
3. Rendon RA, Kapoor A, Breau R, et al. Surgical management of renal characteristics of those who experienced a complication and those who
cell carcinoma: Canadian Kidney Cancer Forum Consensus. Can had not. Multivariable Cox proportional hazard analysis was used to
Urol Assoc J 2014;8:E398-412. https://doi.org/10.5489/cuaj.1894 assess the association between age at time of surgery, primary interven-
4. Valverde I, Gomez G, Coserria JF, et al. 3D printed models for tion, and pubectomy on the risk of having a complication.
planning endovascular stenting in transverse aortic arch hypo- Results: Median age at time of surgery was 44 years (interquartile range
plasia. Catheter Cardiovasc Interv 2015;85:1006-12. https://doi. [IQR] 29–56), and the most common mechanism of injury was motor
org/10.1002/ccd.25810 vehicle accident (MVA) (53.4%). Eighty-five percent of patients had ure-
5. Zheng Y, Yu D, Zhao J, et al. 3D printout models vs. 3D-rendered thral injury distal to the external sphincter. Initial management was most
images: Which is better for preoperative planning? J Surg Educ often primary realignment with urethral catheter (61.5%) or suprapubic
2016;73:518-23. https://doi.org/10.1016/j.jsurg.2016.01.003 tube alone (38.5%). Ultimately, 97.5% of patients underwent primary
6. Malik HH, Darwood ARJ, Shaunak S, et al. Three-dimensional print- perineal anastomosis after a median of seven months (IQR 5–14). Overall,
ing in surgery: A review of current surgical applications. J Surg Res 26/116 evaluable patients (22.4%) had a long-term complication after a
2015;199:512-22. https://doi.org/10.1016/j.jss.2015.06.051 median 25 months (IQR 7–66), including stricture recurrence, de novo
7. Liew Y, Beveridge E, Demetriades AK, et al. 3D printing of patient- ED, and post-void dribbling. Only 5/116 patients (4.3%) had stricture
specific anatomy: A tool to improve patient consent and enhance recurrence after a median time of eight months (IQR 5–12); all were man-
imaging interpretation by trainees. Br J Neurosurg 2015;29:712-4. aged with urethral dilations as needed. Nineteen patients developed some
https://doi.org/10.3109/02688697.2015.1026799 degree of de novo ED, and this was more common among patients who
had a pubectomy (79% vs. 21%; p=0.044). On multivariable analysis,
UP-2.3 no predetermined variables predicted for complications.
Conclusions: The rate of stricture recurrence after primary anastomosis
One-year outcomes of dorsal buccal mucosal graft urethroplasty for PFUI is low. Pubectomy was associated with de novo ED. Despite a
for vesicourethral anastomotic stenosis post-radical diverse patient population, we did not identify predictors of complications
prostatectomy following reconstruction.
Walid Shahrour , Ahmed Kotb , Owen Prowse , Hazem Elmansy 1
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1 Clinical Sciences, Northern Ontario School of Medicine, Thunder Bay,
ON, Canada UP-2.5
Introduction: We aimed to evaluate the one-year outcomes of using dorsal Predictive factors for recurrent urinary tract infections in
buccal mucosal graft (BMG) for the repair of refractory vesicourethral patients with a history of spinal cord injury
anastomotic stenosis (VUAS) post-open radical prostatectomy. Ross Everett , David Charles , Halle Foss , Michael Avallone , R. Corey
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Methods: Patients’ demographics, preoperative continence status, num- O’Connor , Michael Guralnick 1
1
ber of dilations, and urine flow preoperatively and postoperatively were 1 Urologic Surgery, Medical College of Wisconsin, Milwaukee, WI,
collected. Patients were discharged home on day 1. Trial of void and United States
retrograde urethrogram were done after three weeks. Flow and post-void Introduction: We sought to assess associations between demographic,
residual were done at three months. Cystoscopy was done at six months clinical, and urodynamic variables and recurrent urinary tract infection
to assess patency. (UTI) in spinal cord injury (SCI) patients performing clean intermittent
Results: The cohort included five patients between July 2018 and February catheterization (CIC).
2019. The median age was 67 (59–72) years. Four of five patients (80%) Methods: The records of 136 SCI patients who perform CIC for bladder
had received adjuvant radiotherapy. The median number of preopera- management were retrospectively reviewed. All had a video urodynamics
tive endoscopic procedures, including dilations and incisions, was seven study (VUDS) available for analysis. Subjects were divided into recurrent
(4–10). The median stricture length was 2.5 cm (2–3). All patients were (rUTI) UTI (>3/year) or non-rUTI (<3/year) groups. Differences between
incontinent preoperatively with median preoperative flow of 5 mL/s (3–7). the cohorts were analyzed. Multivariable logistic regression was per-
Median operative time and blood loss were 150 minutes and 250 mL, formed to assess for associations between demographic, clinical, and
respectively. Mean postoperative urine flow at 16 months was 20 mL/s VUDS variables and rUTI, both self-reported and culture-proven.
(17–23). Median followup was 16 (9–16) months. All patients were incon- Results: Self-reported rUTI were noted in 58 of 136 (42.6%) patients. A
tinent postoperatively. Success rate was 100% at 16 months. One patient higher body mass index (BMI) was identified in patients with self-reported
had artificial urinary sphincter postoperatively and it is successful at the rUTI (26.4 vs. 24.8; p=0.048). Culture-proven rUTI were recorded in 30 of
16-month time point. 124 (24.2%) patients. Differences between groups with and without rUTI
Conclusions: BMG urethroplasty in vesicourethral anastomotic stricture/ are listed in Table 1. Non-white race (African American or other) was sig-
stenosis is a new technique that can provide a safe perineal approach nificantly more prevalent in the culture-proven rUTI group. Additionally,
while eliminating the potential risk of rectal injury and urethral atrophy those with rUTI were closer to the time of their SCI. On multivariable
from extensive urethral mobilization. It can also decrease the need for lapa- logistic regression, women demonstrated a stronger association with rUTI
rotomy or the need to perform a combined abdominal-perineal approach. than men (odds ratio [OR] 4.96; p=0.011), African American was more
Long-term followup is warranted with a larger cohort of patients. strongly associated with rUTI compared to Caucasian race (OR 5.16;
p=0.002), and a longer time since injury showed a decreased associa-
UP-2.4 tion (OR 0.91; p=0.036) with rUTI. There were no significant differences
in urodynamic variables between groups and none were significant on
Outcomes of pelvic fracture urethral injury reconstruction regression as predictors of rUTI.
Sarah R. Ferrara , Taylor Remondini , Amanda Hird , Jennifer A. Locke , Conclusions: Race, gender, and time since SCI appear to play a role in
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Sender Herschorn , Ronald T. Kodama 1 the risk of rUTI in SCI patients using CIC. Urodynamic variables, however,
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1 Urology, Sunnybrook Health Sciences Centre, University of Toronto, were not found to be predictive of rUTI in this population.
Toronto, ON, Canada
Introduction: Urethral injury is a complication of pelvic fracture in males,
with variable rates of erectile dysfunction (ED) and stricture recurrence fol-
lowing reconstruction. Our objective was to analyze pelvic fracture ure-
S58 CUAJ • June 2020 • Volume 14, Issue 6(Suppl2)