Study evaluates cognitive and manual dexterity disorders after AUS placement


"We found a 25% incidence of cognitive impairment just based on this telephone test," says Jacqueline Zillioux, MD.

In this video, Jacqueline Zillioux, MD, provides the background for 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.


Please describe the background for this study.

This study was looking at the incidence of cognitive impairment and/or manual dexterity disorder diagnoses in men who underwent an artificial urinary sphincter after treatment for prostate cancer. Artificial urinary sphincters are the well-accepted gold standard for severe or persistent bothersome stress incontinence after prostate cancer treatment. And our guidelines acknowledge that patients need a certain level of cognitive and manual dexterity function to safely utilize these devices. The patient has to activate them appropriately every time he goes to void, otherwise [he] risks issues such as device erosion, infections, renal issues. And although the guidelines say that you should be assessing for that upfront, this patient population who's getting implanted is an older population; the average age is around 70 years old. That's the same population that's at risk of developing new cognitive or dexterity issues. And yet, we have hardly any data on that, until now, thankfully. And so our institution actually did a cross sectional telephone-based study where we looked at patients who had had an implant in the past and called the patients, did a telephone MoCA exam of cognitive screening tests in patients who answered. We found a 25% incidence of cognitive impairment just based on this telephone test and in our patient population. Those patients were more likely to report not using the device correctly.

This transcription was edited for clarity.

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