Publication date: Aug 01, 2026
Stress urinary incontinence (SUI) remains a debilitating complication after treatment for prostate cancer or benign prostatic obstruction. While artificial urinary sphincter (AUS) implantation is the gold standard, sling procedures are widely adopted for selected patients. We aimed to analyze long-term trends, perioperative outcomes, and explantation patterns of AUS and sling procedures for male SUI in Germany. We performed a population-based study using the German Nationwide Inpatient Sample (GRAND) from 2005 to 2023. Men undergoing AUS or sling implantation were identified through procedure codes. Primary outcomes were in-hospital morbidity, mortality, and length of stay (LOS). Multivariable regression models were adjusted for age, comorbidities, prior radiotherapy, and year of surgery. Reasons for explantation and reimplantation were also assessed. A total of 24 234 men underwent SUI surgery (AUS: 63%, nonadjustable sling: 32%, and adjustable sling: 4. 7%). Median age was 72 yr. AUS implantation remained most frequent, although it declined slightly in recent years. Use of nonadjustable sling peaked in 2012 but decreased thereafter, whereas use of adjustable sling procedures increased steadily. Procedure volumes markedly decreased during COVID-19. Perioperative mortality was
| Concepts | Keywords |
|---|---|
| Debilitating | Artificial urinary sphincter |
| Germany | Perioperative outcomes |
| Models | Sling |
| Prostate | Stress urinary incontinence |
| Radiotherapy |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | prostate cancer |
| pathway | KEGG | Prostate cancer |
| drug | DRUGBANK | Gold |
| disease | MESH | COVID-19 |