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Comparison of complication rates related to male urethral slings and artificial urinary sphincters for urinary incontinence: national multi-institutional analysis of ACS-NSQIP database.
Int Urol Nephrol. 2016 Oct; 48(10):1571-6.IU

Abstract

PURPOSE

Male stress urinary incontinence (SUI) can significantly diminish quality of life and lead to embarrassment and social withdrawal. Surgical therapies, such as male urethral slings and artificial urinary sphincters (AUS), are considered effective and safe treatments for male SUI. Our objective is to evaluate 30-day complications in patients undergoing male slings and AUS placement from a national multicenter database.

METHODS

Data from the American College of Surgeons National Surgical Quality of Improvement Program for 2008-2013 were used to identify patients who underwent male slings and AUS implantation. Trained coders abstracted complication data from the patient record independent of the surgical team. We compared 30-day postoperative complications for male slings and AUS. We examined the relationship between patient factors and complication rates for each procedure type.

RESULTS

Overall, 1205 incontinence surgeries in men were identified: 597 male sling placements and 608 AUS implantations. Male sling placement had a lower 30-day postoperative complication rate compared to AUS (2.8 vs. 5.1 %, p = 0.046). Compared to AUS, male sling was associated with fewer urinary tract infections (0.3 vs. 2.0 %, p = 0.020) and return trips to the operating room (1.0 vs. 3.0 %, p < 0.001). Patients with higher BMI were more likely to have a complication, while age, race and Charlson comorbidity index were not associated with higher or lower complication rates.

CONCLUSIONS

Complications rates for both male sling and AUS are low. Male sling is associated with a lower rate of complications than AUS. These findings allow for better patient perioperative counseling regarding 30-day perioperative complications.

Authors+Show Affiliations

Department of Urology, King Abdulaziz University, P. O. Box 80215, Jeddah, 21589, Saudi Arabia. amjadwal@yahoo.com. Department of Urology, University of California San Francisco, San Francisco, CA, USA. amjadwal@yahoo.com.Department of Urology, University of California San Francisco, San Francisco, CA, USA.Department of Urology, University of California San Francisco, San Francisco, CA, USA.Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.Department of Urology, University of California San Francisco, San Francisco, CA, USA.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

27417131

Citation

Alwaal, Amjad, et al. "Comparison of Complication Rates Related to Male Urethral Slings and Artificial Urinary Sphincters for Urinary Incontinence: National Multi-institutional Analysis of ACS-NSQIP Database." International Urology and Nephrology, vol. 48, no. 10, 2016, pp. 1571-6.
Alwaal A, Harris CR, Awad MA, et al. Comparison of complication rates related to male urethral slings and artificial urinary sphincters for urinary incontinence: national multi-institutional analysis of ACS-NSQIP database. Int Urol Nephrol. 2016;48(10):1571-6.
Alwaal, A., Harris, C. R., Awad, M. A., Allen, I. E., & Breyer, B. N. (2016). Comparison of complication rates related to male urethral slings and artificial urinary sphincters for urinary incontinence: national multi-institutional analysis of ACS-NSQIP database. International Urology and Nephrology, 48(10), 1571-6. https://doi.org/10.1007/s11255-016-1347-3
Alwaal A, et al. Comparison of Complication Rates Related to Male Urethral Slings and Artificial Urinary Sphincters for Urinary Incontinence: National Multi-institutional Analysis of ACS-NSQIP Database. Int Urol Nephrol. 2016;48(10):1571-6. PubMed PMID: 27417131.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of complication rates related to male urethral slings and artificial urinary sphincters for urinary incontinence: national multi-institutional analysis of ACS-NSQIP database. AU - Alwaal,Amjad, AU - Harris,Catherine R, AU - Awad,Mohannad A, AU - Allen,Isabel E, AU - Breyer,Benjamin N, Y1 - 2016/07/14/ PY - 2016/04/27/received PY - 2016/06/14/accepted PY - 2016/7/16/entrez PY - 2016/7/16/pubmed PY - 2017/5/23/medline KW - ACS-NSQIP KW - Artificial urinary sphincter KW - Complications KW - Male urethral sling KW - Urinary incontinence SP - 1571 EP - 6 JF - International urology and nephrology JO - Int Urol Nephrol VL - 48 IS - 10 N2 - PURPOSE: Male stress urinary incontinence (SUI) can significantly diminish quality of life and lead to embarrassment and social withdrawal. Surgical therapies, such as male urethral slings and artificial urinary sphincters (AUS), are considered effective and safe treatments for male SUI. Our objective is to evaluate 30-day complications in patients undergoing male slings and AUS placement from a national multicenter database. METHODS: Data from the American College of Surgeons National Surgical Quality of Improvement Program for 2008-2013 were used to identify patients who underwent male slings and AUS implantation. Trained coders abstracted complication data from the patient record independent of the surgical team. We compared 30-day postoperative complications for male slings and AUS. We examined the relationship between patient factors and complication rates for each procedure type. RESULTS: Overall, 1205 incontinence surgeries in men were identified: 597 male sling placements and 608 AUS implantations. Male sling placement had a lower 30-day postoperative complication rate compared to AUS (2.8 vs. 5.1 %, p = 0.046). Compared to AUS, male sling was associated with fewer urinary tract infections (0.3 vs. 2.0 %, p = 0.020) and return trips to the operating room (1.0 vs. 3.0 %, p < 0.001). Patients with higher BMI were more likely to have a complication, while age, race and Charlson comorbidity index were not associated with higher or lower complication rates. CONCLUSIONS: Complications rates for both male sling and AUS are low. Male sling is associated with a lower rate of complications than AUS. These findings allow for better patient perioperative counseling regarding 30-day perioperative complications. SN - 1573-2584 UR - https://www.unboundmedicine.com/medline/citation/27417131/Comparison_of_complication_rates_related_to_male_urethral_slings_and_artificial_urinary_sphincters_for_urinary_incontinence:_national_multi_institutional_analysis_of_ACS_NSQIP_database_ L2 - https://doi.org/10.1007/s11255-016-1347-3 DB - PRIME DP - Unbound Medicine ER -