(140) CHANGES IN SEXUAL QUALITY OF LIFE IN PATIENTS WITH STRESS URINARY INCONTINENCE TREATED WITH AN ARTIFICIAL URINARY SPHINCTER; ANALYSIS OF THE ARTIFICIAL URINARY SPHINCTER CLINICAL OUTCOMES TRIAL (AUSCO)
Authors: Jones L , Terlecki R , Peterson A , Wood H , Chaussee E , Rainbow K , Vanni A , Broghammer J , Henry G , Breyer B , Erickson B , Burnett A , Johnsen N , Chan L , Meyer J , Flynn B , Khavari R , Smith T , Elliott S , Kaufman M 
Published: December 2024

Abstract

Introduction
The artificial urinary sphincter (AUS) remains a “gold standard” in the treatment of male stress urinary incontinence (SUI). Despite being a standard of care for over 50 years, there is sparse data regarding the connection between SUI and sexual quality of life (QoL).

Objective
To examine the relationship between SUI and sexual QOL in men treated with the AUS. Analysis of the sexual health-related Incontinence Quality of Life (IQoL) item 22 in patients before and after AUS implant provides insight to understanding of this relationship.

Methods
The Artificial Urinary Sphincter Clinical Outcomes Trial (AUSCO) is a single-arm, prospective, multi-center study designed to evaluate objective and subjective outcomes of men with SUI treated with the AMS 800. This was approved by each institutional committee on ethics in human investigation (NCT04088331). A total of 115 patients served as their own controls and follow-up assessments at 12-months post device activation were compared to baseline values. The change in response to IQoL item 22, “I worry about having sex because of my urinary problems or incontinence,” was analyzed between baseline and 12 months. Patients who had ED recorded in their baseline medical history were also analyzed separately.

Results
Of the 115 implanted patients, 98 patients completed IQoL assessments at 12 months as of May 2024. Overall, there was a statistically significant improvement in responses to level of worry about having sex due to urinary problems (p &lt; 0.001, Table 1). Improvement was observed in men with (p = 0.031) and without ED (p &lt; 0.001). Specifically, 43.3% (39/90) of men without ED reported feeling “extremely” worried about having sex at baseline, which fell to 12.2% (11/90) at 12 months. Conversely, their responses of “not at all” worried about having sex increased from 18.9% (17/90) at baseline to 40.0% (36/90) at 12 months. Men with ED who reported being “extremely” worried about having sex decreased from 50% (4/8) at baseline to 25% (2/8) at 12 months. The number of responses of “not at all” worried about having sex increased from 0% at baseline to 12.5% (1/8) at 12 months. Lower pad weight and decreased pad use post-AUS were associated with improvement in this sexual quality of life measure. Improvement in sexual QOL was independent of age, BMI, and diabetes.

Conclusions
Men with and without ED showed an improvement in sexual quality of life at 12 months post AUS. The treatment of SUI in men with the AUS improves their level of worry as it relates to sexual activity.

Disclosure
Yes, this is sponsored by industry/sponsor: Boston Scientific Corporation.
Clarification: Industry initiated, executed and funded study.
Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific Corporation.