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Purpose <p>To systematically assess perioperative complications after artificial urinary sphincter (AUS) implantation using the European Association of Urology (EAU) complication reporting guidelines and evaluate long-term device outcomes.</p> Methods <p>We retrospectively analyzed male patients undergoing AUS implantation between 2015 and 2020. Demographic, clinical, and surgical characteristics were described. Early complications within 6&#xa0;weeks were captured using a procedure-specific complication catalog and graded according to the Clavien–Dindo Classification (CDC), in line with EAU standardized reporting recommendations. Primary endpoints were overall and major complications (CDC grade ≥ III); secondary endpoint was explantation-free survival.</p> Results <p>A total of consecutive 227 AUS implantations (median age 73&#xa0;years, IQR 67–76) were included. Severe stress urinary incontinence was predominantly post-radical prostatectomy (81%). Cuff types included distal double cuff (58%), bulbar single cuff (26%), and transcorporal cuff (16%). Complications occurred in 47% of cases, most frequently bleeding events (61%), followed by genitourinary (12%) and infectious events (11%). Major complications requiring a reintervention occurred in 7.9% of cases. Median follow-up was 52&#xa0;months (IQR 32–66), with 5-year explantation-free survival of 73%. Explantation was required in 23% of cases, primarily due to urethral erosion and infection.</p> Conclusion <p>AUS implantation is associated with frequent early complications, though most are minor. Applying a predefined, procedure-specific complication catalog according to EAU guidelines ensures systematic, comprehensive, and transparent reporting. This approach highlights clinically relevant events, supports cross-study comparability, and informs individualized patient counseling and perioperative management.</p>

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Standardized reporting of perioperative complications after male artificial urinary sphincter implantation

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月10日

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  • Navid Roessler,
  • Malte W. Vetterlein,
  • Tim H. J. Konrad,
  • Robert J. Schulz,
  • Max C. Wagner,
  • Jakob Klemm,
  • Shahrokh F. Shariat,
  • Roland Dahlem,
  • Margit Fisch,
  • Tim A. Ludwig

摘要

Purpose

To systematically assess perioperative complications after artificial urinary sphincter (AUS) implantation using the European Association of Urology (EAU) complication reporting guidelines and evaluate long-term device outcomes.

Methods

We retrospectively analyzed male patients undergoing AUS implantation between 2015 and 2020. Demographic, clinical, and surgical characteristics were described. Early complications within 6 weeks were captured using a procedure-specific complication catalog and graded according to the Clavien–Dindo Classification (CDC), in line with EAU standardized reporting recommendations. Primary endpoints were overall and major complications (CDC grade ≥ III); secondary endpoint was explantation-free survival.

Results

A total of consecutive 227 AUS implantations (median age 73 years, IQR 67–76) were included. Severe stress urinary incontinence was predominantly post-radical prostatectomy (81%). Cuff types included distal double cuff (58%), bulbar single cuff (26%), and transcorporal cuff (16%). Complications occurred in 47% of cases, most frequently bleeding events (61%), followed by genitourinary (12%) and infectious events (11%). Major complications requiring a reintervention occurred in 7.9% of cases. Median follow-up was 52 months (IQR 32–66), with 5-year explantation-free survival of 73%. Explantation was required in 23% of cases, primarily due to urethral erosion and infection.

Conclusion

AUS implantation is associated with frequent early complications, though most are minor. Applying a predefined, procedure-specific complication catalog according to EAU guidelines ensures systematic, comprehensive, and transparent reporting. This approach highlights clinically relevant events, supports cross-study comparability, and informs individualized patient counseling and perioperative management.