Prevalence of Cognitive and Manual Dexterity Disorders Among Men Following Artificial Urinary Sphincter Placement.

Autor:	Zillioux J; Department of Urology, University of Virginia Health System, Charlottesville, Virginia., Camacho FT; Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia., Anderson RT; Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia., You W; Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia., Rapp DE; Department of Urology, University of Virginia Health System, Charlottesville, Virginia.
Jazyk:	angličtina
Zdroj:	The Journal of urology [J Urol] 2024 Sep; Vol. 212 (3), pp. 441-450. Date of Electronic Publication: 2024 May 24.
DOI:	10.1097/JU.0000000000004049
Abstrakt:	Purpose: Cognitive ability and manual dexterity sufficient to operate an artificial urinary sphincter (AUS) are critical for device function and safety. We aimed to define the incidence of cognitive and/or dexterity disorders among men after AUS. We secondarily aimed to assess for association between these disorders and postimplant complications. Materials and Methods: This is a retrospective cohort study using the SEER (Surveillance, Epidemiology, and End Results)-Medicare linked database (2000-2018). We included men ≥ 66 years diagnosed with prostate cancer between 2001 to 2015 who subsequently underwent AUS placement. We excluded patients with < 1-year continuous fee-for-service Medicare enrollment or cognitive and/or manual dexterity disorder diagnoses prior to AUS implant. Subsequent cognitive/dexterity disorders and implant-related complications were queried using appropriate ICD (International Classification of Diseases)-9/10 and/or CPT (Current Procedural Terminology) codes. Associations between cognitive/dexterity disorders and postimplant complications were assessed using extended Cox proportional hazards modeling. Secondary analysis focused on serious complications (device revision/removal, Fournier's gangrene, urethral erosion). Results: We identified 1560 men who underwent AUS who met inclusion criteria. Median age was 73.0 (IQR 70-77) years. Cumulative incidence function analysis estimated 44% and 17% incidence of cognitive and manual dexterity disorder, respectively, at 15 years post-AUS. Presence of cognitive with/without manual dexterity disorder was associated with increased hazard of any, but not serious, complication during follow-up. Conclusions: A significant proportion of patients develop cognitive and/or manual dexterity disorders following AUS. These data support the need for close longitudinal monitoring after implant.
Databáze:	MEDLINE
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