Pragmatic reporting system for complications of male stress urinary incontinence surgeries (COMUS)

Abstract

Objective:: The aim of this review is to evaluate existing classification systems for surgical complications in male stress urinary incontinence (SUI) management, specifically highlighting the limitations of the widely used Clavien–Dindo classification in addressing infection-related complications. Additionally, this review introduces a novel reporting system, the pragmatic Complication Reporting System for Male Stress Urinary Incontinence Surgeries (COMUS), designed to improve the classification of complications and enhance clinical outcomes. Evidence Acquisition:: SUI is a frequent postoperative complication that significantly impairs the quality of life in patients following surgeries for both malignant and benign prostate diseases. Surgical interventions such as artificial urinary sphincter and sling implantation carry a risk of complications, necessitating a robust system for evaluating and comparing outcomes. The Clavien–Dindo classification, although widely used, fails to adequately address the specific challenges in managing male SUI, particularly in relation to infections. Results:: The newly developed pragmatic COMUS system classifies complications based on the level of intervention required for resolution, distinguishing between invasive and non-invasive treatments. Furthermore, it accounts for infection-related complications, which are often not fully addressed in other classification systems. Conclusion:: The pragmatic COMUS system improves upon existing frameworks by incorporating infection management and grading complications according to treatment needs. This more comprehensive classification enhances the accuracy of outcome evaluation, ultimately aiding clinicians in making better-informed decisions for managing male stress urinary incontinence.

Keywords

• Urinary incontinence
• Artificial urinary sphincter
• AUS