Day-case artificial urinary sphincter implantation in a low-volume centre: Feasibility with an experienced surgeon

To assess the feasibility and safety of day-case artificial urinary sphincter (AUS) implantation in a low-volume centre performing 5 to 10 procedures per year, with a single experienced surgeon.

We conducted a retrospective single-centre study including all consecutive patients who underwent AUS implantation or reimplantation under day-case conditions between March 2022 and December 2025. Eligibility criteria for day-case surgery were: ASA score≤3, availability of a companion at home, and residence within 90minutes of the centre. The primary outcome was the absence of any unscheduled re-hospitalisation or unscheduled outpatient visit within 7days of surgery. Secondary outcomes included complication rates at 3months graded by the Clavien-Dindo classification, and functional outcomes assessed by pad usage at 3, 6 and 12months.

Twenty-five consecutive procedures were included, comprising 23 primary implantations and 2 reimplantations. Day-case surgery was successfully completed in 24 out of 25 patients (96%). Eighteen patients (72%) met the definition of a fragile urethra. Overall complications within 3months occurred in 5 patients (20%), with a single Clavien grade≥3 complication (4%) consisting of AUS explantation following an infected inguinal haematoma with prosthetic material exposure. The overall continence rate (0 or 1 pad per day) was 92% at 3months, 95% at 6months and 88% at 12months.

Day-case AUS implantation is feasible in a low-volume centre, including in patients with a fragile urethra, when performed by an experienced surgeon, with short-term outcomes comparable to those reported in high-volume academic series.