Dr. Zillioux discusses incidence of cognitive and manual dexterity disorders after AUS placement

In this video, Jacqueline Zillioux, MD, discusses notable findings from the Journal of Urology study “Prevalence of Cognitive and Manual Dexterity Disorders Among Men Following Artificial Urinary Sphincter Placement.” Zillioux is an assistant professor of urology at the University of Virginia in Charlottesville.

Transcription:

What were some of the notable findings? Were any of them surprising to you and your coauthors?

[This] was a retrospective cohort study of the SEER Medicare and Medicare files, which is a registry that's maintained nationally of patients with cancer diagnoses. We looked at men that had a diagnosis of prostate cancer between the years 2000 and 2015 and had subsequently undergone an artificial sphincter implantation. We looked broadly at cognitive impairment diagnoses and also manual dexterity diagnoses based on CPT codes and looked at the incidence of those over time and also looked at complication rates. We found 1930 patients that met our inclusion criteria. We surprisingly had to exclude patients that had baseline cognitive or manual dexterity impairment. What was surprising was that we had to exclude 322 of these patients. Those are patients that normally per our guideline would not be a candidate for an implant, potentially. And of the 1900 or so patients that were included, we found that over time, when you are controlling for possible competing risk of death because of age, that there was an estimated 44% incidence of cognitive impairment diagnosis at 15 years and 17% for manual dexterity diagnosis at 15 years. But when we looked at the complication rates based off of presence of any of those diagnoses, adjusted modeling showed that only cognitive impairment with or without manual dexterity was associated with an increased risk of any complication with a hazard ratio of about 1.5, but manual dexterity diagnoses alone were not. We also did a sub analysis looking at just those complications that were more serious, so patients that needed to have a device revision, for example, or had Fournier's or urethra erosion and we did not find a significant difference based on the presence of those diagnoses for that, but did find it for just overall.

This transcription was edited for clarity.