MP52-19 SURGICAL LEARNING CURVE OF POSTERIOR URETHROPLASTY FOR RADIATION-INDUCED BULBOMEMBRANOUS URETHRAL STRICTURES

METHODS: We retrospectively reviewed all patients that underwent SPT placement at our institution from 2008-2015. We identified 68 patients that received SPTs for radiation-induced urethral strictures and had a minimum of 6 months follow-up. Patient and stricture characteristics were recorded. RESULTS: Among 68 patients with radiation-induced urethral strictures who underwent SPT placement at our institution, 31/68 (46%) chose to continue with a chronic SPT whereas 37/68 (54%) elected to subsequently undergourethral reconstruction. Patients electing a chronic SPTwere slightly older than those undergoing reconstruction (72.9 years versus 70.1 years, p1⁄4 0.16), but otherwise shared similar characteristics. Stress urinary incontinence (SUI) at time of initial presentation was reported by 22/31 (71%) patients and resolved after SPT placement in 9/22 (41%) patients. The majority of patients (16/31 (51.2%)) managed with a chronic SPT reported no side effects. Development of bladder stones occurred in 7/31 (22.6%) patients and 12/31 (38.7%) patients reported irritative bladder symptoms, the majority of whom (7/12 (58.3%)) had radiation-induced cystitis. Five patients with refractory radiation cystitis ultimately underwent ileal conduit urinary diversion for their symptoms. CONCLUSIONS: Chronic SPT can be a successful initial management strategy for refractory radiation-induced urethral strictures in patients unwilling to undergo open urethral reconstruction. SPT is overall well tolerated and can resolve incontinence in nearly half of patients.