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Longitudinal changes in patient-reported outcomes after artificial urinary sphincter implantation
Minato Yokoyama1, Hitoshi Masuda1,2, Masaya Ito1,3
1Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan.
Lower Urinary Tract Symptoms
|April 14, 2020
Summary
Artificial urinary sphincter (AUS) implantation significantly improves continence and quality of life. While initial symptom relief is substantial, long-term outcomes show a slight decline in continence, though lower urinary tract symptoms remain stable.
Area of Science:
- Urology
- Medical Devices
- Patient Outcomes
Background:
- Severe urinary incontinence significantly impacts patients' quality of life.
- Artificial urinary sphincter (AUS) implantation is a surgical option for managing refractory urinary incontinence.
- Understanding the longitudinal changes in lower urinary tract symptoms (LUTS) post-AUS is crucial for patient management.
Purpose of the Study:
- To evaluate the time course of lower urinary tract symptoms (LUTS) after artificial urinary sphincter (AUS) implantation.
- To analyze individual longitudinal changes in patient-reported outcomes following AUS implantation.
- To assess the long-term efficacy and symptom progression after AUS surgery.
Main Methods:
- Retrospective study of 66 male patients undergoing primary AUS implantation (2009-2019).
- Utilized International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and International Prostate Symptom Score (IPSS) for assessments.
- Longitudinal data analyzed using linear mixed models to determine annual score changes.
Main Results:
- 95% of patients achieved social continence (≤1 pad/day) within 1 month post-activation.
- Significant improvements in ICIQ-SF, IPSS, and IPSS-QOL scores were observed immediately after AUS activation (P < .001).
- While continence and QOL scores showed a slight deterioration over time, improved LUTS were generally maintained, with only incomplete emptying showing a significant longitudinal worsening (0.08/year, P=.029).
Conclusions:
- Artificial urinary sphincter implantation provides immediate and significant improvement in continence and quality of life.
- A slight, but statistically significant, deterioration in continence and QOL scores occurs over time post-implantation.
- Lower urinary tract symptoms, apart from incomplete emptying, are largely maintained long-term after AUS surgery.
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