Quality of life and patient satisfaction after artificial urinary sphincter.

Published on January 31, 2011

January 2011

This study confirms that men benefit from improved quality of life after insertion of the artificial urinary sphincter for incontinence after prostate surgery.

Background: We assessed satisfaction and quality of life (QOL) in men with artificial urinary sphincter (AUS) placement.

Methods: We identified 39 men who had AUS placement. A retrospective chart review was conducted. Validated questionnaires were used to measure patient reported outcome, including the International Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF), Post-Operative Patient Global Impression of Improvement(PGI-I), Incontinence Impact Questionnaire – Short Form(IIQ-SF), and Urogenital Distress Index(UDI-SF). Global satisfaction was also assessed.

Results: At chart review, 34 of 39 questionnaires were assessed for QOL, satisfaction, and surgical outcome. Follow-up ranged from 7 to 60 months (median=24 months). Surgical revisions were required in 6 (17.6%) patients due to infection (1), erosion (1), combined infection and erosion (1), device failure (1), and second cuff placement (2). QOL was assessed using the IIQ-SF and UDI-SF, with mean scores of 15.4 and 24.8 respectively, indicating low negative impact on QOL. The ICIQ-SF mean score was 8.2, well below the worst possible score. The number of men using more than 1 pad per day dropped from 27 pre-operatively to 10 post-operatively. Majority of patients (31/34) described their urinary condition as better, two had no change, and one was worse. Most patients (31/34, 91.2%) would be willing to undergo the procedure again, two were undecided, and one wouldn’t. Similarly, 28 patients (82.4%) responded they would recommend the procedure to a friend, three replied they would ‘with reservation’, one was undecided, and two wouldn’t recommend it.

Conclusion: Treatment of urinary incontinence with the AUS has a positive effect on QOL with high patient satisfaction and reasonably low complication rates.

Kahlon B, Baverstock R, Carlson K.
Canadian Urology Association Journal 2011 Jan 13.