Artificial Urinary Sphincter Complications: Risk Factors, Workup, and Clinical Approach

Area of Science:

• Urology
• Medical Devices

Background:

• Artificial urinary sphincter (AUS) implantation is a primary treatment for stress urinary incontinence (SUI).
• Complications, both minor and major, can occur post-implantation.
• Understanding risk factors is key to mitigating adverse events.

Purpose of the Study:

• To identify established risk factors for complications following artificial urinary sphincter (AUS) insertion.
• To present a systematic algorithm for the diagnosis and management of AUS complications.

Main Methods:

• Review of established risk factors for AUS complications.
• Presentation of a diagnostic and management algorithm.

Main Results:

• Key risk factors identified include catheterization, transurethral resection of the prostate (TURP), pelvic radiation, urethroplasty, anticoagulation, cardiovascular disease, diabetes mellitus, frailty index, hypertension, low albumin, and low testosterone.
• A systematic approach to diagnosis and management of both early and late complications is outlined.
• Proactive consideration of patient-specific risk factors can aid in complication prevention.

Conclusions:

• A thorough understanding of potential AUS complications is essential for urologists.
• Effective management of complications can restore quality of life for men with SUI.
• Systematic diagnosis and management strategies improve patient outcomes.