Artificial Urinary Sphincter in Male Patients Requiring Urethral Instrumentation: Is It a Challenge?

Urethral instrumentation (UI) in patients with an artificial urinary sphincter (AUS) requires technical assessments and carries a risk of urethral erosion, causing severe clinical and legal results.

An electronic survey was administered to the members of the Society of Urological Surgery in Turkey between 15th November and 15th December 2025. The survey consists of 20 multiple-choice items addressing sociodemographic characteristics, urological sub-field interests, knowledge about AUS components and functionality, AUS training, experience with UI in AUS patients, practice patterns, and interest in further training.

Of 286 participants (mean age 43.32 ± 9.03), 66.1% reported playing a role in urological emergencies, with 88.1% reporting insufficient training during their residency. Besides, 50.3% had occasional or regular involvement with AUS surgeries. Only 29.0% reported knowing AUS components and 39.2% reported feeling confident in deactivating it. From the aspect of urethral catheterization, 50.0% had knowledge of the safe catheter diameter, and 20.3% identified safe catheterization duration. Even though 33.2% self-reported competence in UI, many participants gave incorrect responses regarding catheter size and catheterization duration. Self reported-competence was found to have strong correlation with knowledge about AUS components (OR 0.049 [%95 CI: 0.021-0.117]), prior experience (OR 0.355 [95% CI: 0.151-0.834]). The main limitation of the study is the subjective responses from a limited number of participants.

The present study revealed significant gaps regarding Turkish urologists' training and knowledge of UI in AUS patients. The findings emphasize the potential for a better training to enhance patient outcomes and minimize AUS-related complications in Turkey.

It was not deemed necessary because it was a survey study.