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PD32-07 ANDROGEN DEPRIVATION THERAPY IS ASSOCIATED WITH URETHRAL ATROPHY AND ARTIFICIAL URINARY SPHINCTER CUFF EROSION

INTRODUCTION AND OBJECTIVES: Prior studies have shown that men with low serum testosterone appear to have a higher risk of artificial urinary sphincter (AUS) cuff erosion. However, the urethral sequelae of androgen deprivation therapy (ADT) among AUS patients have not been well studied. We hypothesized that men on ADT for advanced prostate cancer may be at increased risk for urethral atrophy and AUS complications. METHODS: In our large AUS database of cases performed by a single surgeon 2007-2018 at a tertiary urban medical center, we identified two group of men: those who had received ADT (typically with radiation) and those with known normal serum testosterone (T) levels without a history of ADT or radiation. Demographic and outcome data were collected and analyzed to determine trends in cuff sizes used in these men and rates of urethral erosion. Use of a 3.5 cm AUS cuff was defined as a surrogate for urethral atrophy and compared between groups. RESULTS: From our database of 643 AUS cases during the study interval, we identified 67 (10.4%) who had been on ADT and 32 (5%) with normal T and no history of prior ADT or radiation. In these groups, 17 (26.2%) men on ADT developed AUS cuff erosion compared with 1 (3.7%) in the normal T group, which was significant on univariate analysis (p=0.02). A 3.5 cm AUS cuff was utilized more commonly among the ADT group (32/67, 48.5%) compared with the control group (9/32, 28.1%, p=0.08). Among men with 3.5 cm cuffs, the rates of urethral erosion were significantly higher among men who had been on ADT (31.2%) compared with the control group (11.1%, p=0.04). CONCLUSIONS: Men with a history of ADT appear to have a greater likelihood of urethral atrophy, as manifested by increased use of 3.5 cm AUS cuff. This further supports the adverse relationship between hypogonadism and urethral homeostasis, which may contribute to increased rates of AUS cuff erosion. AUS patients receiving ADT for advanced prostate cancer should be counseled appropriately regarding this elevated risk. Source of Funding: None