The findings, published in the
Journal of Urology, come from a study led by Farnoosh Nik-Ahd, Department of Urology, University of California, San Francisco, California, and colleagues. The researchers examined whether frailty influences postoperative outcomes in older men undergoing surgery for
stress urinary incontinence (SUI).
Stress urinary incontinence is a common complication following prostate cancer treatment and can significantly impair quality of life. Artificial urinary sphincters and male urethral slings are established surgical treatments for SUI, but many patients are older adults with reduced physiological reserve. While age and comorbidities are often considered during surgical planning, the independent impact of frailty on postoperative outcomes has been less well understood.
To investigate this, researchers conducted a retrospective study of 7,252 Medicare beneficiaries who underwent AUS implantation or male urethral sling surgery between 2014 and 2016. Frailty was assessed using the Claims-Based Frailty Index (CFI), categorizing patients as not frail, prefrail, or mildly-to-severely frail. The primary outcomes included 30-day postoperative complications and device revision or removal within one year.
Key findings from the study include:
- Among the 7,252 patients, 62.2% underwent AUS implantation and 37.8% received a urethral sling. The mean age was 74.2 years.
- Thirty-day postoperative complications occurred in 15% of patients, while 11% required device revision or removal within one year.
- Increasing frailty was independently associated with a higher risk of 30-day complications. Compared with non-frail patients, the risk increased by 50% in prefrail individuals and 150% in mildly-to-severely frail patients.
- Older age was also associated with higher complication rates, with patients aged 75–84 years and 85 years or older experiencing progressively greater risks than those aged 66–74 years.
- Frailty and advancing age independently predicted device revision or removal within one year, whereas comorbidity burden alone was not significantly associated with this outcome.
The researchers concluded that frailty was a stronger predictor of adverse surgical outcomes than comorbidity alone, supporting routine frailty assessment during preoperative evaluation and shared decision-making.
They acknowledged limitations including the retrospective design, reliance on Medicare claims data, lack of detailed clinical and patient-reported information, and potential selection bias.
Overall, the findings indicate that frailty independently increases the risk of postoperative complications and device revision after AUS or urethral sling surgery, highlighting the value of incorporating frailty assessment into preoperative counseling and patient selection.
Reference:
Nik-Ahd F, Dreyfuss LD, Wang L, Shatkin-Margolis A, Boscardin WJ, Hampson LA, et al. Frailty Is Associated With Postoperative Complications and Device Removal and Revision in Men Undergoing Surgery for Stress Urinary Incontinence. Journal of Urology [Internet]. [cited 2026 Jul 27];0(0). Available from: https://doi.org/10.1097/JU.0000000000005102
Disclaimer: This website is primarily for healthcare professionals. The content here does not replace medical advice and should not be used as medical, diagnostic, endorsement, treatment, or prescription advice. Medical science evolves rapidly, and we strive to keep our information current. If you find any discrepancies, please contact us at corrections@medicaldialogues.in. Read our Correction Policy here. Nothing here should be used as a substitute for medical advice, diagnosis, or treatment. We do not endorse any healthcare advice that contradicts a physician's guidance. Use of this site is subject to our Terms of Use, Privacy Policy, and Advertisement Policy. For more details, read our Full Disclaimer here.
NOTE: Join us in combating medical misinformation. If you encounter a questionable health, medical, or medical education claim, email us at factcheck@medicaldialogues.in for evaluation.