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Day-case artificial urinary sphincter for post-prostatectomy incontinence: A comparative pilot study.

Konstantinos Kapriniotis¹, Ioannis Loufopoulos¹, Richard Nobrega¹

¹Department of Urology, University College London Hospital UCLH@ Westmoreland Street London UK.

|September 26, 2024

Summary

Day-case artificial urinary sphincter (AUS) implantation is feasible and safe for selected patients with post-prostatectomy incontinence (PPI). Outcomes, including continence and complications, are comparable to traditional overnight stays.

Keywords:

artificial urinary sphincter day‐case outpatient surgery post‐prostatectomy incontinence

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Published on: June 16, 2022

Area of Science:

Urology
Surgical Innovation
Patient Care Management

Background:

Artificial urinary sphincter (AUS) implantation for post-prostatectomy incontinence (PPI) traditionally involves an overnight hospital stay.
Optimizing surgical pathways and patient discharge protocols is crucial for improving healthcare efficiency.

Purpose of the Study:

To assess the feasibility and outcomes of performing artificial urinary sphincter (AUS) implantation in a day-case surgical setting.
To compare the success of same-day discharge, complication rates, and continence outcomes between day-case and overnight stay AUS procedures.

Main Methods:

A prospective, comparative pilot study included patients undergoing primary or redo AUS surgery over 18 months.
Patients were offered day-case surgery, with a control group receiving standard overnight care.
Primary outcome was successful same-day discharge; secondary outcomes included complications and 1-year continence rates.

Main Results:

Eight of 12 patients (66.7%) in the day-case group were successfully discharged on the same day.
Reasons for failed same-day discharge included anesthetic recovery, high post-void residuals, and minor urethral injury.
Continence rates at 1 year were comparable between the day-case group (all socially continent) and the overnight group (all but one socially continent).

Conclusions:

Day-case catheter-free discharge following artificial urinary sphincter (AUS) implantation is feasible and safe for selected patients.
This approach offers comparable continence outcomes and complication rates to standard overnight stays, suggesting potential for improved healthcare efficiency.