Cognitive, manual dexterity disorders prevalent in men with AUS implant

Men who undergo artificial urinary sphincter placement (AUS) tend to develop cognitive or manual dexterity disorders, reveals a study. 

A total of 1,560 men (median age 73.0 years) who underwent AUS met the eligibility criteria for this study. At 15 years following AUS, the cumulative incidence of cognitive and manual dexterity disorders among the participants was estimated at 44 percent and 17 percent, respectively. 

Additionally, the presence of cognitive with or without manual dexterity disorders contributed to a higher risk of any, but not serious, complication during follow-up. 

“These data support the need for close longitudinal monitoring after implant,” the investigators said.  

This retrospective cohort study used the Surveillance, Epidemiology, and End Results (SEER)–Medicare-linked database (2000–2018) and included men aged 66 years and above who had been diagnosed with prostate cancer between 2001 and 2015 and subsequently underwent AUS placement.  

Those with less than 1-year continuous fee-for-service Medicare enrolment or cognitive and manual dexterity disorder diagnoses before AUS implantation were excluded. 

The investigators evaluated the subsequent cognitive/dexterity disorders and implant-related complications using appropriate ICD–9/10 or Current Procedural Terminology codes. They then examined the associations between cognitive/dexterity disorders and postimplant complications using an extended Cox proportional hazards modelling. 

In the secondary analysis, the investigators focused their attention on serious complications, such as device revision or removal, Fournier’s gangrene, and urethral erosion. 

“Cognitive ability and manual dexterity sufficient to operate an AUS are critical for device function and safety,” the investigators said.