Significant post-prostatectomy incontinence (PPI) is a crippling condition and managed
best through sling or artificial urinary sphincter (AUS) implantation. These procedures
are often associated with complications requiring surgical intervention. The aim of
our retrospective study was to evaluate the occurrence of major complications and
identify risk factors. MATERIALS AND METHODS: Between 2010 and 2018 ninety-one
patients have been implanted with sling (22; 24.2%) or AUS (69; 75.8%) in our department.
The cases where surgical revision was needed were examined regarding the etiology
(mechanical failure (MF), urethral erosion (UE), urethral atrophy (UA), surgical site
infection (SSI), combined reasons (COMB) and analyzed, using 16 possible perioperative
risk factors.Surgical intervention was carried out by 19 / 91 (20.9%) patients. (In
16 / 69 cases after AUS (23.1%), 3 / 13 after slings (23%)). The indication was in
6 (31.6%) cases MF, in 3 (15.8 %) COMB, in 4 (21.1%) UE, in 5 (26.3 %) SSI, in 1 (5.2%)
UA. The type of reoperation was either explantation (12 / 19), system replacement
(6 / 19), or cuff replacement (1 /19). Regarding the surgical intervention requiring
complications only preoperative bacteriuria (P = .006) and postoperative surgical
site oedema (P = .002) proved to be independent predictive factors. CONCLUSION: Preoperative
bacteriuria and surgical site oedema seemed to be good predictors for obligate surgical
revision. Patients with AUS were more prone to have major complications. In most cases
it was mechanical failure, infection or erosion. By reducing the frequency of these
risk factors we might be able to decrease the amount of complications.
