title: Quality of life and continence assessment of the artificial urinary sphincter in men with minimum 3.5 years of followup.
abstract: OBJECTIVE
  We determined the long-term efficacy and quality of life impact of the artificial urinary sphincter.
  
  
  METHODS
  We reviewed the medical records of 68 men who underwent artificial urinary sphincter placement for post-prostatectomy incontinence (64) or neurogenic disease (4) between March 1980 and March 1992 (mean followup 7.2 years). Quality of life was assessed in 52 patients who completed the incontinence impact questionnaire and the urogenital distress inventory.
  
  
  RESULTS
  At followup 54 men were socially continent (0 or 1 pad per day). Overall, pad score decreased significantly from 2.75 before to 0.97 after artificial urinary sphincter implantation (p < 0.001). The artificial urinary sphincter was permanently removed in 4 patients. Revisions for mechanical failure or urethral atrophy were required in 25% of the patients (mean 1.35 procedures per patient). The mechanical failure rate decreased significantly after 1987 due to device improvements (12.4 versus 44.4%, p < 0.01). Subjective improvement and overall satisfaction were rated as 4.1 and 3.9, respectively (scale 0 to 5). At followup the mean values of the incontinence impact questionnaire and urogenital distress inventory demonstrated the positive impact of the artificial urinary sphincter on quality of life.
  
  
  CONCLUSIONS
  This long-term study documents the positive impact of the artificial urinary sphincter on patient quality of life with few mechanical failures since 1987.
authors.affiliation: Urology Department, Kaiser Permanente Medical Center, Los Angeles, California, USA.
authors.forename: F
authors.initials: F
authors.lastname: Haab
authors.forename: B A
authors.initials: BA
authors.lastname: Trockman
authors.forename: P E
authors.initials: PE
authors.lastname: Zimmern
authors.forename: G E
authors.initials: GE
authors.lastname: Leach
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery*; D016741:Urinary Sphincter, Artificial