URINARY INCONTINENCE Psychological aspect of qualification to implant an artificial urethral sphincter AMS 800

Abstract

IntroductionImplantation of the AMS 800 artificial urethral sphincter is a “gold standard” in the treatment of total urinary incontinence in men. Appropriate qualification of patients to urinary incontinence treatment determines the higher effectiveness of this method. Service of this device requires physical fitness and mental efficiency from a patient.Material and methodsThe Urological Clinic hospitalized 16 patients, aged from 60 to 80 years, after first qualification for artificial urethral sphincter implantation. Psychological assessment was carried out during anamnesis and medical examination using the MMSE and the GDS.ResultsPsychological deviations were found in 7 out of 16 examined patients, but finally 2 patients were disqualified because of their cognitive function disorders with elements of low level depressive syndrome (1) and benign cognitive and member function disorders (1). Among the patients who were examined by a psychologist: four of them showed mild (3) and temperate (1) features of depressive syndrome and one patient showed benign cognitive disorder without dementia. However, none of these findings were contraindications to incontinence treatment with an artificial urethral sphincter.Conclusions1. Mild and temperate features of depression syndrome are not absolute contraindications for a sphincter AMS 800 implantation. These patients need only pharmacological treatment. 2. Cognitive and other memory disorders are contraindications to this method. 3. The qualification to implantation an artificial urethral sphincter should include a psychological assessment, especially in older patients in whom mental disorders are suspected.