The Role of Educational Level and Cognitive Status in Men Undergoing Artificial Urinary Sphincter Implantation.

Urology 2020 Sep 2. Epub 2020 Sep 2.

Firat University School of Medicine, Department of Urology, Elazig, Turkey.

Objective: To examine the relationship between education level, cognitive function of patients and the success/ revision rates of artificial urinary sphincter (AUS) implantation in men with postprostatectomy incontinence.

Methods: Between January 2010 and March 2018, 163 patients (mean age, 68 ± 6.8 years) with moderate-to-severe stress urinary incontinence who underwent AUS implantation were retrospectively examined. Demographic data, body mass index, comorbidities, surgical technique, previous strictures, and radiation therapy were recorded. Incontinence was measured by daily pad use and evaluated by International Consultation on Incontinence Questionnaire-short form. Patients' overall improvement was assessed using the Patient Global Impression of Improvement questionnaire. Education level was determined using the International Standard Classification of Education. Cognitive status was assessed using the Mini-Mental State Examination. Treatment success was defined as the need for ≤1 pad/day at last follow-up.

Results: AUS was successful in 77.3% of patients. The International Consultation on Incontinence Questionnaire-short form score improved significantly from 19.9 ± 2.9 to 4.4 ± 5.4 (P = .001). The median outcome reported subjectively on the Patient Global Impression of Improvement scale was 2.1 ± 1.5 (1-7) and self-reported as "much better." Patients' education level had statistically no significant relationship with AUS success and revision rates. Similarly, there was no significant relationship between cognitive status, educational level and the need for revision of AUS (P >.05). However, patients with moderate cognitive impairment and a body mass index >30 showed significantly lower AUS success rates (P <.05).

Conclusion: AUS implantation is safe and effective treatment option especially for nonobese and cognitively intact patients of all educational levels.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.urology.2020.05.112DOI Listing
September 2020

Publication Analysis

Top Keywords

cognitive status
12
education level
12
questionnaire-short form
8
patient global
8
global impression
8
urinary sphincter
8
impression improvement
8
incontinence questionnaire-short
8
aus success
8
body mass
8
aus implantation
8
international consultation
8
consultation incontinence
8
artificial urinary
8
revision rates
8
level cognitive
8
educational level
8
aus
6
cognitive
5
level
5

Similar Publications