Mp03-06 Incidence of Cognitive and Manual Dexterity Disorders Among Men With Artificial Urinary Sphincters: A Seer Medicare Study

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence (MP03)1 May 2024MP03-06 INCIDENCE OF COGNITIVE AND MANUAL DEXTERITY DISORDERS AMONG MEN WITH ARTIFICIAL URINARY SPHINCTERS: A SEER MEDICARE STUDY Jacqueline Zillioux, Katherina Chen, Wen You, Roger T. Anderson, Fabian T. Camacho, and David E. Rapp Jacqueline ZilliouxJacqueline Zillioux , Katherina ChenKatherina Chen , Wen YouWen You , Roger T. AndersonRoger T. Anderson , Fabian T. CamachoFabian T. Camacho , and David E. RappDavid E. Rapp View All Author Informationhttps://doi.org/10.1097/01.JU.0001009488.55564.85.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Cognitive ability and manual dexterity sufficient to operate an artificial urinary sphincter (AUS) are critical for device function and safety. We aimed to define the incidence of cognitive and/or dexterity disorders among men after AUS. We secondarily aimed to assess for association between these disorders and post-implant complications. METHODS: This is a retrospective cohort study using the SEER Medicare linked database (2000-2018). We included men≥66 years diagnosed with prostate cancer between 2001-2015 who subsequently underwent AUS placement. We excluded patients with <1-year continuous fee-for-service Medicare enrollment or cognitive and/or manual dexterity disorder diagnoses prior to AUS implant. Subsequent cognitive/dexterity disorders and implant-related complications were queried using appropriate ICD9/10 and/or CPT codes. Associations between cognitive/dexterity disorders and post-implant complications were assessed using extended Cox-proportional hazards modeling. Secondary analysis focused on serious complications (device revision/removal, Fournier's gangrene, urethral erosion). RESULTS: 1,560 men who underwent AUS met inclusion criteria. Mean age was 73.8(4.3) years and mean follow-up was 6.5(4.1) years. Overall, 398(25.5%) and 131(8.4%) patients developed subsequent cognitive and manual dexterity disorders, respectively (Figure 1). In total, 871(55.6%) patients had a post-implant complication, including 525(33.6%) device removals at mean 3.1(3.2) years. Cox proportional-hazard modeling found cognitive with/without manual dexterity disorder resulted in increased hazard of any, but not serious complication (Table 1). CONCLUSIONS: A significant proportion of patients develop cognitive and/or manual dexterity disorders following AUS. These data support the need for close longitudinal monitoring after implant; however, data are encouraging that serious complication rates are similar to those without cognitive/dexterity disorders. Download PPT Source of Funding: Boston Scientific Corporation © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e24 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Jacqueline Zillioux More articles by this author Katherina Chen More articles by this author Wen You More articles by this author Roger T. Anderson More articles by this author Fabian T. Camacho More articles by this author David E. Rapp More articles by this author Expand All Advertisement PDF downloadLoading ...