Patient Risk Factors Associated with Reported Urinary Quality of Life Following Artificial Urinary Sphincter Placement: A Paired Pre and Postoperative Analysis

Rachel A. Moses; Joshua A. Broghammer; Benjamin N. Breyer; Bryan B. Voelzke; Jill C. Buckley; Brad A. Erickson; Sean Elliott; Alex J. Vanni; Niveditta Ramkumar; Jeremy B. Myers

doi:10.1016/j.urology.2022.07.023

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Patient Risk Factors Associated with Reported Urinary Quality of Life Following Artificial Urinary Sphincter Placement: A Paired Pre and Postoperative Analysis

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Patient Risk Factors Associated with Reported Urinary Quality of Life Following Artificial Urinary Sphincter Placement: A Paired Pre and Postoperative Analysis

Rachel A. Moses, Joshua A. Broghammer, Benjamin N. Breyer, Bryan B. Voelzke, Jill C. Buckley, Brad A. Erickson, Sean Elliott, Alex J. Vanni, Niveditta Ramkumar and Jeremy B. Myers

Urology (Ridgewood, N.J.), Vol.169, pp.226-232

11/2022

DOI: 10.1016/j.urology.2022.07.023

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Abstract

To evaluate potential associations between patient risk factors and incontinence related patient-reported outcome measures (PROMs) preandpost artificial urinary sphincter (AUS) implantation. We hypothesize patient risk factors, including prior radiation and diabetes will have a negative association with post AUS PROMs. A review of prospectively collected preandpostoperative Incontinence Symptom Index [ISI] and Incontinence Impact Questionnaire-7 (IIQ-7)s from multiple institutions in the Trauma and Urologic Reconstruction Network of Surgeons was performed. Changes in preandpost AUS ISI and IIQ-7 scores were compared for the entire cohort then stratified by patients with prior AUS, obesity, diabetes, prior radiation, and mixed urinary incontinence. A total of 145 patients, 67.2 (SD 10.9) years had complete preandpost AUS questionnaires (median follow up 186 days, IQR 136-362). Post AUS ISI and IIQ-7 scores improved significantly for the group at large. Prior radiation was associated with less improvement in total IIQ-7 scores, -25.5 (31.9) vs -39 (33.0), P = .03. Obesity was associated with a greater reduction in incontinence severity -13.6 (SD 9.1) vs -9.2 (SD 8.9), P<0.01, urge -5.2(SD 4.2) vs -2.5(SD 4.5), P <.01, and total ISI score -29.7(SD19.7) vs -21.2 (SD 19.9), P = .02. Prior AUS, diabetes, and mixed incontinence were not associated with post AUS PROMs outcome. Overall, patients reported a significant reduction in incontinence severity, bother, impact, and distress following AUS placement. Prior radiation was associated with less improvement in total IIQ-7 scores. In contrast, obesity demonstrated a greater reduction in ISI severity and urge scores compared to non-obese patients.

Details

Title: Subtitle: Patient Risk Factors Associated with Reported Urinary Quality of Life Following Artificial Urinary Sphincter Placement: A Paired Pre and Postoperative Analysis
Creators: Rachel A. Moses - Dartmouth–Hitchcock Medical Center
Joshua A. Broghammer - University of Kansas
Benjamin N. Breyer - University of California, San Francisco
Bryan B. Voelzke - Spokane Urology, Spokane, WA
Jill C. Buckley - University of California San Diego
Brad A. Erickson - University of Iowa
Sean Elliott - University of Minnesota
Alex J. Vanni - Lahey Hospital and Medical Center
Niveditta Ramkumar - Dartmouth–Hitchcock Medical Center
Jeremy B. Myers - University of Utah
Resource Type: Journal article
Publication Details: Urology (Ridgewood, N.J.), Vol.169, pp.226-232
DOI: 10.1016/j.urology.2022.07.023
ISSN: 0090-4295
eISSN: 1527-9995
Publisher: Elsevier Inc
Language: English
Date published: 11/2022
Academic Unit: Urology
Record Identifier: 9984320060402771

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