PD37-09 PREVALENCE OF COGNITIVE IMPAIRMENT AND SPHINCTER MISUSE AMONG MEN WITH ARTIFICIAL URINARY SPHINCTERS

Abstract

INTRODUCTION AND OBJECTIVE: As the population ages, a growing number of patients will suffer progressive cognitive decline, both normal and pathological. The association between cognitive impairment and loss of independence in activities of daily living is well documented and relates to both memory loss and functional decline in abilities like manual dexterity. These deficits can be particularly problematic for patients with artificial urinary sphincters (AUS). We aimed to define the prevalence of cognitive impairment and sphincter misuse among our institutional cohort of AUS patients. METHODS: Men who had undergone primary AUS placement or revision surgery at our institution from 2004-2019 were invited to participate in telephone surveys. Patients answered questions regarding current urinary symptoms, quality of life, medical history, AUS use, and urologic follow-up. Validated telephone mini-mental status exams (T-MMSE) were completed to assess cognitive function. Patients were categorized by degree of cognitive impairment and analyzed using appropriate statistical comparison tests. RESULTS: A total of 142 unique patients were identified; 74 participated in the study (61% response rate, excluding 20 deceased patients). Median age and follow-up since AUS implantation were 76 [69, 81] and 7 [4, 11] years, respectively. Some degree of cognitive impairment was seen in 18 (24%) patients: 13 (18%) mild, 2 (3%) moderate, and 3 (4%) severe. Table 1 compares patient characteristics, revision and continence rates, and sphincter usage patterns in those with normal versus impaired cognition. Twenty-three (31%) patients reported they did not cycle their device with every void, and 11 (15%) reported they were no longer using their AUS. Notably, 50% of patients with impaired cognition were not cycling their device with every void compared to 25% among those with normal cognition. Over half of all patients with impaired cognition had not seen a urologist in the last year. CONCLUSIONS: Our study revealed significant rates of cognitive impairment and sphincter misuse among men with artificial urinary sphincters. These data suggest there may be a role for monitoring cognitive function and long-term follow-up in these patients. Further prospective study of cognitive decline and related outcomes in AUS patients is warranted.Source of Funding: No source of funding