The Artificial Urinary Sphincter Improves Emotional Health in Men With Stress Urinary Incontinence: Results From the Prospective, Multi-institutional AUSCO Study

OBJECTIVE: To examine the effects on depression, anxiety, and overall emotional health in patients undergoing artificial urinary sphincter (AUS) surgery for stress urinary incontinence (SUI). Few reports focus on the impact of AUS implantation on emotional health in men with SUI. METHODS: The AUS Clinical Outcomes Trial (AUSCO) was a prospective, single-arm, multi-site study designed to evaluate outcomes in men with SUI treated with the AMS 800 AUS (NCT04088331). A total of 115 subjects were implanted. Follow-up assessments at 3-, 6-, and 12-months post device activation were compared to baseline. These analyses focus on emotional health, measured with the Incontinence QOL (I-QOL), Incontinence Impact Questionnaire (IIQ-7), and EQ-5D-5L. RESULTS: At 12 months, 100 had completed QOL assessments. Depression rating (Item 5, I-QOL) significantly improved, with 85% (85/100) of patients reporting feeling at least "a little" depressed at baseline decreasing to 39% (39/100) at 12 months (p<0.0001). Emotional health rating (Item 6, IIQ-7) also improved, with 16% (16/100) reporting being "greatly" affected by incontinence at baseline decreasing to 3% (3/100) at 12 months (P <.0001). The anxiety/depression domain on the EQ-5D-5L (Item 5) was also significantly improved, with 50% (50/100) of patients reporting being at least "slightly" anxious or depressed at baseline decreasing to 30% (30/100) at 12 months (P =<0.0001). CONCLUSION: These data demonstrate that treatment of SUI with the AUS improves emotional health in men with SUI.