Day-case versus conventional inpatient artificial urinary sphincter implantation: A single-center comparative study of 177 patients.

PURPOSE: Ambulatory artificial urinary sphincter (AUS) implantation has been proposed as an alternative to conventional inpatient surgery, but comparative data remain limited. We aimed to compare early postoperative outcomes between day-case and conventional inpatient AUS implantation at a single tertiary center.

MATERIALS AND

METHODS

We retrospectively analyzed all primary AUS (AMS 800) implantations performed at our institution between November 2018 and December 2025. Patients were allocated to ambulatory (Group A, n=126) or conventional hospitalization (Group B, n=51). Group B included patients with ASA score≥3 or social conditions incompatible with same-day discharge. The primary endpoint was a composite of early complication or hospital readmission within 30 days.

RESULTS

The composite primary endpoint occurred in 14/124 (11.3%) ambulatory and 4/49 (8.2%) conventional patients (P=0.78). Early complication rates (11.3 vs. 8.0%, P=0.60), 30-day readmission rates (4.0 vs. 6.1%, P=0.69), and severe complication rates (Clavien-Dindo≥III: 14.4 vs. 20.4%, P=0.36) did not differ significantly. Kaplan-Meier analysis showed comparable explantation-free (P=0.61) and revision-free (P=0.55) survival. On univariate analysis, anticoagulant therapy was associated with higher complication risk in ambulatory patients (OR 4.00, P=0.040), but this was not confirmed on multivariate analysis. Limitations include the retrospective design, selection bias, and limited sample size.

CONCLUSIONS

Day-case AUS implantation is feasible and safe in selected patients, with outcomes comparable to conventional inpatient management. These findings support the broader adoption of ambulatory surgical pathways for AUS implantation.

LEVEL OF EVIDENCE: III.