The Patient Beyond the Sphincter–Cognitive and Functional Considerations Affecting the Natural History of Artificial Urinary Sphincters

Abstract Artificial urinary sphincters (AUS) are common. Life expectancy at average implantation (71.5 years) is 14 years. During this period patients must still possess manual dexterity and cognitive capabilities needed to operate the AUS, otherwise it is practically unfunctional. Still, available data regarding AUS durability deal with medical&mechanical factors. Issues as age related deteriorating manual dexterity&cognitive capabilities precluding patients from operating an apparently intact AUS have not been addressed. We set to focus on these aspects. We review the natural history of manual dexterity, physical and cognitive deterioration of aging men and propose counselling and screening algorithms for evaluating these aspects.