Andrew C. Peterson, MD, MPH, on counseling men regarding the artificial urinary sphincter

In this video, Andrew C. Peterson, MD, MPH, discusses implications from the study “The Artificial Urinary Sphincter Improves Depression, Anxiety and Overall Emotional Health in Men With Stress Urinary Incontinence; Analysis of the Artificial Urinary Sphincter Clinical Outcomes Trial (AUSCO),” which he presented at the 2024 Sexual Medicine Society of North America Fall Scientific Meeting in Scottsdale, Arizona. Peterson is a professor of surgery at Duke University in Durham, North Carolina.

Transcription:

How can these findings be translated into clinical practice to optimize patient care and improve outcomes for men with SUI?

I think the component we as surgeons have always concentrated on is these very objective physical exam findings to relate to quality of life and to relate success of any device or surgery. For instance, any abstract or paper has to have number of pads and pad weight change in order to tell you that a device is working well for treatment of incontinence. I think that now we have good data that patient-reported outcomes have to be considered in these patient populations. We now have data that the PROs indicate significant anxiety and effects on quality of life, and the men being able to live their life normally and unencumbered and do things they want to do on a daily basis, and we've seen significant improvement with that with this study, and it's just an observational study. We've probably always seen that. The problem is, as surgeons, I don't think we've recognized that component and given it its due attention, and today is the day that I think we need to start doing this; in other words, start paying attention to how we're affecting their anxiety, their depression, their relationships with those around them, and how we're really improving those. Even though we're not going to 0 pads per day, most men are still wearing some, these other components, I think, outweigh the idea that we're not completely treating the incontinence. So an improvement, whatever it is, is really helping these men out, and I think we have to recognize that.

We use it currently in our counseling as well. Now, when I tell this story to men that we're meeting for the first time, maybe 6 months out from their surgery or radiation, or even 5 or 10 or 20 years out from their surgery or radiation, some of them look at it and say, "This is a mechanical thing. It's another surgery. I'm really not interested in surgery." When we tell them about the anxiety and the depression components, typically, we'll see the light go on in their head. Oftentimes, we'll see their family member, partner or spouse light up, as we say these types of things, and I think it can very much help them understand the other benefits they may get from undergoing treatment for male incontinence, such as the quality of life that we've been mentioning.

This transcript was AI generated and edited by human editors for clarity.