OBJECTIVE
To characterize the safety and practice patterns of artificial urinary sphincter (AUS)
placement on a population level. Increasingly AUS implantation has shifted to be an
outpatient surgery; however, there is a lack of large-scale research evaluating factors
associated with early (≤ 24 hours) versus late (>24 hours) discharges and complications
in men following AUS placement. We utilized the National Surgical Quality Improvement
Program (NSQIP) database to identify and compare factors and outcomes associated with
each approach.
METHODS
NSQIP database was queried for men undergoing AUS placement between 2007 and 2016.
Patients were classified as either early discharge (ED ≤ 24 hours) and late discharge
(LD > 24 hours). Baseline demographics, operating time, and complications were compared
between the 2 groups. Multivariate logistic regression evaluated factors associated
with discharge timing and 30-day complications.
RESULTS
A total of 1176 patients were identified and were classified as ED in 232 and LD in
944 patients. Operative time was shorter in ED (83 minutes) compared to LD (95 minutes,
P < .001). Hypertension was more prevalent among LD patients (60.3% vs 69.1% for ED
and LD respectively, P < .001). The 30-day complication rate was similar in both groups (ED: 4.3% vs LD:
3.4%, P = .498). Multivariable analysis revealed that surgery after 2012 was associated with
ED (OR = 3.66, P < .001).
CONCLUSION
At the national level, there are no differences in postoperative morbidity between
early and late discharges. There is a trend toward more ED, specifically after 2012.
A prospective study on the feasibility and safety of outpatient AUS is needed.
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Article Info
Publication History
Published online: October 16, 2020
Accepted:
July 29,
2020
Received:
June 1,
2020
Footnotes
Declarations of interest: None.
Identification
Copyright
Published by Elsevier Inc.
