Day‐case artificial urinary sphincter for post‐prostatectomy incontinence: A comparative pilot study
Abstract Objectives Implantation of an artificial urinary sphincter (AUS) to treat post‐prostatectomy incontinence (PPI) has been traditionally offered with an overnight hospital stay. The aim of this prospective, comparative pilot study was to assess the feasibility and outcomes of the AUS procedur...
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Wiley
2024-09-01
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| Series: | BJUI Compass |
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| Online Access: | https://doi.org/10.1002/bco2.412 |
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| author | Konstantinos Kapriniotis Ioannis Loufopoulos Richard Nobrega Anthony Noah Helena Gresty Tamsin Greenwell Jeremy Ockrim |
| author_facet | Konstantinos Kapriniotis Ioannis Loufopoulos Richard Nobrega Anthony Noah Helena Gresty Tamsin Greenwell Jeremy Ockrim |
| author_sort | Konstantinos Kapriniotis |
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| description | Abstract Objectives Implantation of an artificial urinary sphincter (AUS) to treat post‐prostatectomy incontinence (PPI) has been traditionally offered with an overnight hospital stay. The aim of this prospective, comparative pilot study was to assess the feasibility and outcomes of the AUS procedure in a day‐case setting. Patients and methods We included consecutive patients having primary or redo AUS surgery over an 18‐month period. We excluded patients with previous urethral erosion of AUS, urethroplasty or high anaesthetic risk. All patients were offered day‐case surgery. Patients who declined or could not have day‐case surgery for logistical reasons had standard care with overnight stay and formed the control group for the study. Primary outcome was the proportion of successful same day‐discharges in the day‐case group. We also compared baseline characteristics, complications and continence at 1 year post surgery. Results Twelve patients consented for day‐case procedure, and 13 patients had standard overnight care. Mean age was 69.5 years (range 58–79). Twenty‐one patients (84%) had primary AUS, whereas 4 (16%) had a redo procedure. There were no significant differences between the groups in baseline demographics. Median number of pads/24 h was 5 in the day‐case group and 4 in the overnight group. Eight of 12 patients (66.7%) in the day‐case group were successfully discharged on the same day. Failed discharges were due to anaesthetic recovery (n = 2), high post‐void residuals that resolved spontaneously (n = 1) and intraoperative superficial urethral injury (n = 1). All patients in the day‐case group and all but one in the standard of care group were socially continent (0–1 pads) at 1 year post procedure. Conclusion Day‐case catheter‐free discharge of AUS patients is feasible and safe in selected patients with comparable continence outcomes and complication rates to those with standard overnight stays. |
| format | Article |
| id | doaj-art-acb05b15358d4e7b8fb45926f917fd76 |
| institution | DOAJ |
| issn | 2688-4526 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Wiley |
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| series | BJUI Compass |
| spelling | doaj-art-acb05b15358d4e7b8fb45926f917fd762025-08-20T02:40:32ZengWileyBJUI Compass2688-45262024-09-015995996410.1002/bco2.412Day‐case artificial urinary sphincter for post‐prostatectomy incontinence: A comparative pilot studyKonstantinos Kapriniotis0Ioannis Loufopoulos1Richard Nobrega2Anthony Noah3Helena Gresty4Tamsin Greenwell5Jeremy Ockrim6Department of Urology, University College London Hospital UCLH@ Westmoreland Street London UKDepartment of Urology, University College London Hospital UCLH@ Westmoreland Street London UKDepartment of Urology, University College London Hospital UCLH@ Westmoreland Street London UKDepartment of Urology, University College London Hospital UCLH@ Westmoreland Street London UKDepartment of Urology, University College London Hospital UCLH@ Westmoreland Street London UKDepartment of Urology, University College London Hospital UCLH@ Westmoreland Street London UKDepartment of Urology, University College London Hospital UCLH@ Westmoreland Street London UKAbstract Objectives Implantation of an artificial urinary sphincter (AUS) to treat post‐prostatectomy incontinence (PPI) has been traditionally offered with an overnight hospital stay. The aim of this prospective, comparative pilot study was to assess the feasibility and outcomes of the AUS procedure in a day‐case setting. Patients and methods We included consecutive patients having primary or redo AUS surgery over an 18‐month period. We excluded patients with previous urethral erosion of AUS, urethroplasty or high anaesthetic risk. All patients were offered day‐case surgery. Patients who declined or could not have day‐case surgery for logistical reasons had standard care with overnight stay and formed the control group for the study. Primary outcome was the proportion of successful same day‐discharges in the day‐case group. We also compared baseline characteristics, complications and continence at 1 year post surgery. Results Twelve patients consented for day‐case procedure, and 13 patients had standard overnight care. Mean age was 69.5 years (range 58–79). Twenty‐one patients (84%) had primary AUS, whereas 4 (16%) had a redo procedure. There were no significant differences between the groups in baseline demographics. Median number of pads/24 h was 5 in the day‐case group and 4 in the overnight group. Eight of 12 patients (66.7%) in the day‐case group were successfully discharged on the same day. Failed discharges were due to anaesthetic recovery (n = 2), high post‐void residuals that resolved spontaneously (n = 1) and intraoperative superficial urethral injury (n = 1). All patients in the day‐case group and all but one in the standard of care group were socially continent (0–1 pads) at 1 year post procedure. Conclusion Day‐case catheter‐free discharge of AUS patients is feasible and safe in selected patients with comparable continence outcomes and complication rates to those with standard overnight stays.https://doi.org/10.1002/bco2.412artificial urinary sphincterday‐caseoutpatient surgerypost‐prostatectomy incontinence |
| spellingShingle | Konstantinos Kapriniotis Ioannis Loufopoulos Richard Nobrega Anthony Noah Helena Gresty Tamsin Greenwell Jeremy Ockrim Day‐case artificial urinary sphincter for post‐prostatectomy incontinence: A comparative pilot study BJUI Compass artificial urinary sphincter day‐case outpatient surgery post‐prostatectomy incontinence |
| title | Day‐case artificial urinary sphincter for post‐prostatectomy incontinence: A comparative pilot study |
| title_full | Day‐case artificial urinary sphincter for post‐prostatectomy incontinence: A comparative pilot study |
| title_fullStr | Day‐case artificial urinary sphincter for post‐prostatectomy incontinence: A comparative pilot study |
| title_full_unstemmed | Day‐case artificial urinary sphincter for post‐prostatectomy incontinence: A comparative pilot study |
| title_short | Day‐case artificial urinary sphincter for post‐prostatectomy incontinence: A comparative pilot study |
| title_sort | day case artificial urinary sphincter for post prostatectomy incontinence a comparative pilot study |
| topic | artificial urinary sphincter day‐case outpatient surgery post‐prostatectomy incontinence |
| url | https://doi.org/10.1002/bco2.412 |
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