Same-day surgery for artificial urinary sphincter placement safe and efficient: Study

A group of researchers from the U.S.A conducted a study to analyze our institutional experience transitioning from overnight observation (OBS) to same-day surgery (SDS) for artificial urinary sphincter (AUS) procedures. Prior research has questioned the need for overnight observation (OBS) following AUS surgery.

The researchers retrospectively reviewed AUS surgeries performed by a single surgeon at our tertiary academic medical centre between 08/2013 and 01/2020. Patients were grouped based on discharge status: overnight observation (OBS) vs same-day surgery (SDS). Cost savings associated with SDS were estimated using room and bed charges from a contemporary group of AUS patients.

The results of the study are as follows:

· The researchers identified 525 AUS cases that met inclusion criteria. Men in the same-day surgery (SDS) group (n = 318) were more likely to have undergone a virgin AUS insertion and were slightly younger and healthier.

· Men in the overnight observation (OBS) group (n = 207) were more likely to suffer an immediate postoperative complication and to be readmitted within 90 days of surgery.

· The groups did not vary with respect to multiple other perioperative outcomes measures.

· Among patients who underwent AUS surgery between 09/2017 and 08/2020, those with overnight observation (OBS) status (n = 39) had to mean additional room and bed charges of $ 745 ± 302 vs none for same-day surgery (SDS) patients (n = 183).

Thus, the researchers concluded that same-day surgery (SDS) for AUS insertion is safe, effective, and associated with significant cost savings. Routine overnight observation after AUS insertion appears to be unnecessary.

Reference:

Same-Day Discharge Versus Overnight Observation Protocols – Similar Outcomes Following Artificial Urinary Sphincter Surgery by Dropkin B et.a l published in the Urology.

DOI:https://doi.org/10.1016/j.urology.2021.08.016