Abstracts from the Mid-Atlantic Section of the AUA 2020

MA AUA 2020 Abstracts Traumatic Testicular Injuries in Appalachia: A Ten-Year Review from a Level 1 Trauma Center and Comparison to the National Trauma Data Bank® K. Mitchell 1 ; J. Barnard 2 ; C. Crigger 2 ; D. McClelland 2 ; A. Hajiran 2 ; C. Morley 2 ; J. Knight 3 1 West Virginia University School of Medicine, Morgantown, WV, USA; 2 West Virginia University School of Medicine Department of Urology, Morgantown, WV, USA; 3 West Virginia University School of Medicine Department of Surgery, Division of Trauma and Surgical Critical Care, Morgantown, WV, USA Introduction: To characterize traumatic testicular injuries in Appalachia and compare this data to the National Trauma Data Bank®. Materials &Methods: Aretrospective study was performed on patients presenting with traumatic testicular injuries (TTI) over the past 10 years at our rural tertiary care facility. Results were compared to an 8-year review of 8,030 TTI from the National Trauma Data Bank (NTDB®). Results: Of over 34,000 trauma patients reviewed, 23 (0.07%) had TTI which concurs with the NTDB® value of 0.2%. Blunt trauma accounted for 91.3% of TTI which contrasts with NTDB® data suggesting 50.5%were attributed to penetrating mechanisms. Firearm related injuries comprised 4.3% of TTI whereas MVC/MCC (26.0%), sports (26.0%), work (21.7%), and straddle (13.0%) mechanisms were more common. The NTDB® data suggest 38.3% of TTI are firearm related, while motor vehicle collision (MVC) related trauma had similar incidence toAppalachia at 26.6%. Median length of stay (LOS) was 1 day for the Appalachia cohort with 90.4% of patients undergoing scrotal exploration and 52.4% requiring orchiectomy. NTDB® data suggest a median LOS of 3 days with a 48.3% scrotal exploration rate and 23.4% orchiectomy rate. Conclusions: TTI carry a high risk of organ loss. When compared to the NTDB® TTI data,Appalachia has a higher incidence of blunt mechanism, scrotal exploration rate, and testicular loss possibly due to long transfer times. Based on these findings, increased provider awareness and prompt initiation of transfer to a tertiary care center may improve testicular salvage rates and decrease morbidity. MP5-15 AMulti-Institutional Experience Comparing Outcomes of Patients Undergoing Revisional Robotic Pyeloplasty Versus Primary Robotic Pyeloplasty M. Lee 1 ; Z. Lee 1 ; H. Koster 2 ; M. Jun 3 ;A.Asghar 1 ; R. Lee 1 ; D. Strauss 1 ; M. Stifelman 2 ; L. Zhao 3 ; D. Eun 1 1 Temple University Hospital, Philadelphia, PA, USA; 2 Hackensack University Medical Center, Hackensack, NJ, USA; 3 New York University Langone Health, New York, NY, USA Introduction: We describe amulti-institutional experience comparing perioperative outcomes in patients undergoing revisional robotic pyeloplasty (RRP) versus primary robotic pyeloplasty (PRP). Materials & Methods: We retrospectively reviewed our multi-institutional, Collaborative of Reconstructive Robotic Ureteral Surgery (CORRUS) database to identify all consecutive patients who underwent robotic pyeloplasty for ureteropelvic junction obstruction (UPJO) between 04/2012 and 09/2019. Patients were grouped by those who underwent PRPversus those who underwent RRPafter prior failed pyeloplasty. Our primary outcome was surgical success, defined as the absence of flank pain and absence of ureteral obstruction on radiographic imaging. Continuous and categorical variables were compared using nonparametric, independent sample median and chi-square tests, respectively; p < 0.05 was considered significant. Results: Of 154 patients, 126 (81.8%) underwent PRP, 27 (17.5%) underwent RRP, and 1 (0.6%) underwent an RRP attempt with conversion to nephrectomy. Ten/27 (37.0%) patients underwent ≥1 failed endoscopic procedures prior to RRP. Median time between prior failed pyeloplasty and RRP was 8 months. Of PRP patients, 124/126 (98.4%) underwent dismembered pyeloplasty and 2/126 (1.6%) underwent Y-V pyeloplasty. Of RRP patients, 9/27 (33.3%) underwent buccal mucosa graft pyeloplasty, 5/27 (18.5%) underwent RRPwith a renal pelvis flap, and 13/27 (48.1%) underwent traditional dismembered RRPwithout a renal pelvis flap. RRP patients experienced higher median intraoperative blood losses (100 versus 50 milliliters, respectively; p =< 0.001) and longer median operative times (197 versus 138minutes, respectively; p = 0.031) compared to PRP patients. There was no difference in length of hospital stay (p = 0.166), major (Clavien > 2) complications (p=0.656), and success rates (88.9% versus 92.0%, respectively; p = 0.828) between RRP and PRP patients. Conclusions: RRP can be effective for management of recurrent UPJO after prior failed pyeloplasty. RRP patients may experience higher intraoperative blood losses and longer operative times versus PRP patients. During RRP attempts, there is a small risk of conversion to nephrectomy in patients with poor ureteral tissue quality. MP5-14 Poster Session 5: Urologic Benign Diseases 2 39