The Artificial Urinary Sphincter Improves Emotional Health in Men With Stress Urinary Incontinence: Results From the Prospective, Multi-institutional AUSCO Study - 18/10/25

Doi : 10.1016/j.urology.2025.09.037

Andrew C. Peterson ^a,^⁎ , Hadley M. Wood ^b,^{^{1
Editor-in-Chief.},}^{^{3
Hadley Wood and Bradley Erickson are co-authors.}}, Jeremy Myers ^c, Benjamin N. Breyer ^d, Bradley A. Erickson ^e,^{^{2
Deputy Editor.},}^{^{3
Hadley Wood and Bradley Erickson are co-authors.}}, Thomas G. Smith III ^f, Erin L. Chaussee ^g, Melissa R. Kaufman ^h

AUSCO Collaboration Group
Ryan Terlecki ⁱ, Niels V. Johnsen ^j, Alex J. Vanni ^k, Daniel Moon ^l, LeRoy Jones ^m, Joshua A. Broghammer ⁿ, Gerard Henry ^o, Arthur L. Burnett ^p, Lewis Wen Loong Chan ^q, Brian J. Flynn ^r, Rose Khavari ^s, Sean Elliott ^t

ⁱ Atrium Health Wake Forest Baptist, Winston-Salem, NC

^j Vanderbilt University Medical Center, Nashville, TN

^k Lahey Hospital and Medical Center, Burlington, MA

^l University of Melbourne, Royal Melbourne Clinical School, Melbourne, VIC

^m Urology San Antonio Research, PA, San Antonio, TX

ⁿ University of Kansas Medical Center, Lawrence, KS

^o Willis-Knighton Bossier Medical Center, Bossier City, LA

^p Johns Hopkins Medicine Institutions, Baltimore, MD

^q Concord Repatriation General Hospital, Sydney, NSW

^r University of Colorado, Anschutz Medical Campus, Aurora, CO

^s Houston Methodist Hospital and Weill Cornell Medicine, Houston, TX

^t University of Minnesota, Minneapolis, MN

^a Duke University Medical Center, Durham, NC

^b Glickman Urological Institute, Cleveland, OH

^c University of Utah, Salt Lake City, UT

^d University of California San Francisco, San Francisco, CA

^e University of Iowa Hospitals and Clinics, Iowa City, IA

^f MD Anderson Cancer Center, Houston, TX

^g Boston Scientific, Minnetonka, MN

^h Vanderbilt University Medical Center, Nashville, TN

^* Address correspondence to: Andrew C. Peterson, M.D., M.P.H., Duke University Medical Center, Durham, NC. Duke University Medical Center Durham NC

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Saturday 18 October 2025

ABSTRACT

Objective

To examine the effects on depression, anxiety, and overall emotional health in patients undergoing artificial urinary sphincter (AUS) surgery for stress urinary incontinence (SUI). Few reports focus on the impact of AUS implantation on emotional health in men with SUI.

Methods

The AUS Clinical Outcomes Trial (AUSCO) was a prospective, single-arm, multi-site study designed to evaluate outcomes in men with SUI treated with the AMS 800 AUS (NCT04088331). A total of 115 subjects were implanted. Follow-up assessments at 3-, 6-, and 12-months post device activation were compared to baseline. These analyses focus on emotional health, measured with the Incontinence QOL (I-QOL), Incontinence Impact Questionnaire (IIQ-7), and EQ-5D-5L.

Results

At 12 months, 100 had completed QOL assessments. Depression rating (Item 5, I-QOL) significantly improved, with 85% (85/100) of patients reporting feeling at least “a little” depressed at baseline decreasing to 39% (39/100) at 12 months (p<0.0001). Emotional health rating (Item 6, IIQ-7) also improved, with 16% (16/100) reporting being “greatly” affected by incontinence at baseline decreasing to 3% (3/100) at 12 months ( P <.0001). The anxiety/depression domain on the EQ-5D-5L (Item 5) was also significantly improved, with 50% (50/100) of patients reporting being at least “slightly” anxious or depressed at baseline decreasing to 30% (30/100) at 12 months ( P =<0.0001).

Conclusion

These data demonstrate that treatment of SUI with the AUS improves emotional health in men with SUI.

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Plan

MATERIALS AND METHODS

QOL Questionnaires

Statistical Methods

RESULTS

Summary Scores: I-QOL and IIQ-7

EQ-5D-5L: Summary Score and Domains

QOL Questionnaires: Individual Emotional Health Items

Emotional Health Item Association With Incontinence Improvement

CRediT Authorship Contribution Statement

Declaration of Generative AI and AI-Assisted Technologies in the Writing Process

☆

Given their respective roles as Editor-in-Chief & Deputy Editor, Hadley Wood and Bradley Erickson had no involvement in the peer review of this article and had no access to information regarding its peer review. Full responsibility for the editorial process for this article was delegated to another editor of the journal.