A national survey of urinary and health related quality of life outcomes in men with an artificial urinary sphincter for post-radical prostatectomy incontinence.

PURPOSE

We determine health related quality of life and urinary outcomes of men undergoing implantation of an artificial urinary sphincter for post-radical prostatectomy incontinence.

MATERIALS AND METHODS

Through a data base provided by American Medical Systems, we mailed the UCLA Prostate Cancer Index to men who underwent artificial urinary sphincter implantation during 6-month intervals in 1995 in 1999, providing 5 and 2-year followup data, respectively.

RESULTS

Of the anonymous questionnaires 36% were returned from the 1995 cohort and 45% from the 1999 cohort. Age adjusted mean scores for the 8 health related quality of life domains were comparable in both groups. Urinary function and bother scores were worse in the 1995 cohort compared to the 1999 group (40 and 48 versus 53 and 58, respectively, p <0.001), with pad use of 97% and 83% respectively. Revision rates were 16% at 2 years and 28% at 5 years after implantation.

CONCLUSIONS

Our national survey revealed that despite significant differences in urinary function and bother, men 2 and 5 years after artificial urinary sphincter implantation had similar general health related quality of life. The continence outcomes differed from most single institution studies in that men after sphincter implantation reported a high degree of urinary dysfunction and bother. Artificial urinary sphincter implantation may significantly improve scores in urinary function but continued pad use is to be expected.