Login to Access Video or Poster Abstract: MP46-10
Sources of Funding: None

Introduction

To determine which preoperative factors impact patient quality of life after artificial urinary sphincter (AUS) implantation.

Methods

Men receiving AUS after prostate cancer treatment were identified from a prospectively collected dataset. Preoperative factors were collected at the time of initial incontinence consultation and most patients underwent urodynamic testing before surgery. Patients were surveyed by telephone at least 6 months after AUS, including the EPIC Urinary Domain (EPIC-UD) and Urinary Distress Inventory (UDI-6). Differences in postoperative maximum PPD (mPPD) and instrument scores were compared across preoperative factors using Wilcoxon-Rank sum test or Pearson correlation coefficient, with p≤0.05 indicating significance. Multiple regression analysis was performed with all factors having p≤0.1 on univariate comparisons.

Results

Phone survey was completed by 101 patients. Median age was 69 [63-75] years, BMI was 29 [26-32] kg/m2, and 41 (41%) patients had a history of radiation. Maximum PPD was 5 [3-9] preoperatively and 2 [1-3] postoperatively. Median EPIC-UD was 82 [67-89] and UDI-6 78 [64-89]. Postoperative outcomes did not significantly differ with or without a history of radiation. Postoperative mPPD was significantly lower in patients with the preoperative ability to store urine (2 [1-2] v 2 [1-4], p=0.046). Preoperative mPPD was positively correlated with postoperative mPPD (r=0.255, p=0.011). Regression for postoperative mPPD (R²=0.236, p=0.009) showed decreased use with bladder neck contracture (p=0.032) and lower preoperative mPPD (p=0.030). EPIC-UD was significantly lower with increased detrusor pressure at maximum flow (PdetQmax) (r=-0.346, p=0.013). No other variables were found to be significant. UDI-6 was significantly higher with increased PdetQmax (r=0.413, p=0.003). Regression for UDI-6 (R²=0.200, p=0.005) showed higher score with increased PdetQmax (p=0.005)._x000D_

Conclusions

PdetQmax was most strongly associated with patient-reported outcomes. While postoperative pad use was associated with preoperative pad use, it was not associated with satisfaction as measured by UDI-6 and EPIC-UD.

Funding

None