Expert details artificial urinary sphincter’s impact on depression and anxiety in men

In this video, Andrew C. Peterson, MD, MPH, describes 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:

To what extent do you believe the observed improvements in mental health can be attributed to the direct impact of the AUS on incontinence symptoms, or could other factors such as increased self-esteem or improved social functioning play a role?

I think they all go hand in hand. I think what we definitively have is a device that's been around for over 50 years now that now we know significantly improves quality of life with respect to self well-being, anxiety, anger scores, and depression scores, regardless of if there's confounding factors in there, the results are quite clear. The scores are pretty very bad prior to treatment, while men are leaking, and they go to better than normal, in most cases, after treatment. And these are men that had a number of pads on average that they use—around 4 to 5 pads per day, or 600 cc per day urinary loss preoperatively, and then postoperatively, the average number of pads went to around 1 pad per day. So while we had a significant improvement, not a complete cure of incontinence, we do have this really drastic improvement in these factors of quality of life, meaninganxiety, depression and self well-being.

The implications for the clinician are, I think that there's a very large component of depression, anxiety, and decision regret in these men who are continuing to leak after whatever treatment they've chosen for prostate cancer: radiation, surgery, a combination of those, and even men who have undergone surgeries for benign problems such as BPH. And I think, not to sound drastic or to sound too out of the box with this, but one could say we might even be saving lives with this. There probably is a component of potential self-harm that we're not recognizing in many of these men who are not seeking treatment or are not offered treatment. And then we we really help them out. Most of the principal investigators in this study, anecdotally, when we're discussing these results, do mention that they have had several men come back in their career and say, "I was really on my wit's end. I was very depressed, and I even thought about hurting myself, and this has changed all of that stuff." So it does sound sometimes a little drastic to make those type of statements, but I don't think we can over-read these results. We're significantly helping men with these anxiety, depression, and quality-of-life scores by treating incontinence, and I don't think we knew that before. This is really the first study that has helped us elaborate the components that we just mentioned.

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