Long-term Quality of Life and Functional Outcomes among Primary and Secondary Artificial Urinary Sphincter Implantations in Men with Stress Urinary Incontinence

PURPOSE - There remains a paucity of data regarding subjective and functional outcomes following artificial urinary sphincter (AUS) implantation. Therefore, we evaluated long-term differences in quality of life (QOL) following primary and secondary AUS surgery.

MATERIALS AND METHODS - Men were invited to participate in a mail-in survey assessing AUS status, patient satisfaction, and urinary control. Primary (N=467) and secondary (N=122) AUS devices without an event were included. Differences between cohorts including QOL (10-point scale, maximum 100) and functional outcomes were evaluated.

RESULTS - 229 (49%) primary and 49 (40%) secondary AUS patients completed the survey at a median 8.3 years. Primary and secondary AUS devices reported similar AUS QOL (74 vs 74). There were no significant differences in urinary continence outcomes including ≤1 PPD (56% vs 55%), frequency of leakage ≥1/day (81% vs 71%), or degree of minimal leakage-related bother (64% vs 55%). At

CONCLUSIONS - We noted a high-level of AUS QOL, acceptable urinary control, and no difference in functional outcomes between men undergoing primary or secondary AUS surgery. However, the time-related decline in satisfaction and continence highlights the need for patient counseling regarding long-term AUS functional outcomes.

The Journal of urology. 2016 Mar 17 [Epub ahead of print]

Boyd R Viers, Brian J Linder, Marcelino E Rivera, Laureano J Rangel, Matthew J Ziegelmann, Daniel S Elliott

Department of Urology, Mayo Clinic, Rochester, Minnesota., Department of Urology, Mayo Clinic, Rochester, Minnesota., Department of Urology, Mayo Clinic, Rochester, Minnesota., Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota., Department of Urology, Mayo Clinic, Rochester, Minnesota., Department of Urology, Mayo Clinic, Rochester, Minnesota.