Related Experiment Video
Updated: Aug 25, 2025
Transcorporal Artificial Urinary Sphincter Cuff Placement in a Case Requiring Revision for Urethral Atrophy
Published on: June 16, 2022
Short term reoperation rates after artificial urinary sphincter placement in pediatric patients
Christopher J Loftus1, Jennifer Ahn2, Amanda M Nguyen3
1Department of Urology, University of Washington Medical Center, Seattle, Washington, USA.
Insights
Reoperation rates for pediatric artificial urinary sphincters (AUS) approached 22% within approximately 2.2 years. Concurrent bladder surgery significantly increased reoperation risk in these young patients.
Area of Science:
- Urology
- Pediatric Surgery
- Medical Device Outcomes
Background:
- Artificial urinary sphincters (AUS) are utilized for managing urinary incontinence in pediatric populations.
- Functional outcomes are generally good, but reoperation rates require further investigation.
Purpose of the Study:
- To determine the short-term, nationwide reoperation rates in pediatric patients following artificial urinary sphincter (AUS) placement.
- To identify factors associated with increased reoperation risk in this demographic.
Main Methods:
- An observational cohort study analyzed data from the Truven MarketScan database (2007-2018).
- Pediatric patients (<18 years) undergoing AUS placement were identified.
- Reoperations were defined as device removal, replacement, or subsequent placement; follow-up was calculated from initial placement.
Main Results:
- The final cohort included 45 pediatric patients with a median follow-up of 2.2 years.
- The overall reoperation rate was 22%, with 40% device removals and 60% replacements.
- Concurrent bladder surgery was associated with a significantly higher reoperation rate (50% vs. 12%, p=0.007).
Conclusions:
- The reoperation rate for pediatric artificial urinary sphincters approaches 1 in 4 patients.
- These findings are crucial for counseling patients and parents regarding the risks associated with prosthetic implantation.
Introduction:
Artificial urinary sphincters (AUS) have demonstrated good functional outcomes in pediatric populations. We sought to examine the nationwide short term reoperation rates in pediatric patients after AUS placement.
Materials And Methods:
An observational cohort study was designed utilizing claims from the Truven MarketScan Commercial Claims and Encounters database from 2007 to 2018. Patients under 18 years of age undergoing an AUS procedure were identified using CPT and ICD9/10 codes. Reoperations included any removal, replacement, or AUS placement codes which occurred after the initially identified placement code. Follow up time was the amount of time between AUS placement and the end of MarketScan enrollment.
Results:
From 2007-2018, we identified 57 patients under the age of 18 who underwent AUS placement and after excluding 8 for concurrent AUS complication procedure codes and 4 for follow up < 60 days, the final cohort included 45 patients. The median age was 13 years (IQR 9-16 years) at the time of AUS placement, and the median follow up time after AUS placement was 787 days (IQR 442-1562 days), approximately 2.2 years. Total reoperation rate was 22%. Reoperations included 40% device removals (4/10) and 60% replacements (6/10). Neither gender (p = 0.70) nor age (p = 0.23) was associated with need for reoperation. Patients who had a concurrent bladder surgery had a higher rate of undergoing reoperation (50% vs. 12%, p = 0.007).
Conclusions:
The rate of reoperation after AUS placement approached 1 in 4 in pediatric patients. These data may be instrumental for providers and parents in counseling and decision-making regarding risks of prosthetic implantation.
